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Cardiovascular disease in transgendered people: A review of the literature and discussion of risk.

Seal, LJ (2019) Cardiovascular disease in transgendered people: A review of the literature and discussion of risk. JRSM Cardiovasc Dis, 8. p. 2048004019880745. ISSN 2048-0040 https://doi.org/10.1177/2048004019880745
SGUL Authors: Seal, Leighton John

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Abstract

This review examines the impact of gender affirming hormone therapy used in the transgendered and non-binary populations on cardiovascular outcomes and surrogate markers of cardiovascular health. Current evidence suggests that hormonal therapy for transgendered women decreases or is neutral regarding myocardial infarction risk. There is an increased incidence of venous thromboembolism (VTE), but newer studies suggest that the risk is significantly lower than previously described. For transgendered men, there appears to be an adverse effect on lipid parameters but this does not translate into an increased risk of cardiovascular disease above that of general male population. In all transgendered people, risk factor interventions such as smoking cessation, weight management and treatment of co-morbid conditions are important in optimising cardiovascular health. The effect of gender affirming hormonal therapy in transgendered people is difficult to interpret due to the variety of hormone regimens used, the relative brevity of the periods of observation and the influence of confounding factors such as the historical use of less physiological, oestrogens such as conjugated equine oestrogen and ethinylestradiol which are more pro-thrombotic than the 17β oestradiol that is used in modern practice.

Item Type: Article
Additional Information: © The Author(s) 2019 Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Transgender man, cardiovascular risk, hormone replacement therapy, transgender woman
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: JRSM Cardiovasc Dis
ISSN: 2048-0040
Language: eng
Dates:
DateEvent
30 September 2019Published
10 September 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 31620275
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111396
Publisher's version: https://doi.org/10.1177/2048004019880745

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