Context
The effects of androgen therapy on arterial function in transgender men (TM) are not fully understood, particularly concerning long-term androgen treatment.
Objective
To evaluate arterial stiffness in TM receiving long-term gender-affirming hormone therapy by carotid-femoral pulse wave velocity (cf-PWV).
Design
A cross-sectional case-control study.
Setting
Gender Dysphoria Unit of the Division of Endocrinology, HC-FMUSP, Sao Paulo, Brazil.
Patients
Thirty-three TM receiving intramuscular testosterone (T) esters as regular treatment for an average time of 14 ± 8 years were compared to 111 healthy cisgender men and women controls matched for age and body mass index (BMI). Aortic stiffness was evaluated by cf-PWV measurements using the Complior® device post-testosterone therapy.
Main outcome measures
Aortic stiffness by carotid-femoral pulse wave velocity (cf-PWV) as a cardiovascular risk marker in transgender men and control group.
Results
The cf-PWV after long-term testosterone therapy was significantly higher in TM (7.4 ± 0.9 m/s; range: 5.8–8.9 m/s) than in cisgender men (6.6 ± 1.0 m/s; range: 3.8–9.0 m/s, p < 0.01) and cisgender women controls (6.9 ± 0.9 m/s; range: 4.8–9.1 m/s, p = 0.02). The cf-PWV was significantly and positively correlated with age. Analysis using blood pressure as a covariate showed a significant relationship between TM SBP and cf-PWV in relation to cisgender women but not to cisgender men. The age, the SBP and the diagnosis of hypertension were independently associated with cf-PWV in transgender men group.
Conclusions
The TM group on long-term treatment with testosterone had higher aging-related aortic stiffening than the control groups. These findings indicate that aortic stiffness might be accelerated in the TM group receiving the gender-affirming hormone treatment, and suggest a potential deleterious effect of testosterone on arterial function. Preventive measures in TM individuals receiving testosterone treatment, who are at higher risk for cardiovascular events, are highly recommended.
Purpose
To compare augmentation index (AIx) between one Moderate-intensity continuous physical exercise (MICPE) and one High-intensity interval physical exercise (HIIPE) session in normal/high normal blood pressure (BP) (120–140 for systolic and 80–90 mmHg for diastolic). Additionally, to compare two AIx methods (SphygmoCor® and Arteriograph®) [1].
Methods
Exercise intensity and energy expenditure (equalizing) were according to the cardiopulmonary stress test. Individuals were randomized to exercise sessions, performed as cross-over. AIx were analyzed at baseline, immediately after and 24hours after MICPE and HIIPE session and compared among all times. ΔAIxHIIPE (AIxHIIPE - AIxBaseline) and ΔAIxMICPE were calculated. Correlation and agreement analysis was performed between AIx methods.
Results
Individuals (n = 23; 78% women; 48 ± 1 years; systolic/diastolicBP = 125 ± 2/84 ± 1 mmHg) had lower AIxSphygmoCor® at MICPE compared to baseline and to 24 hours MICPE (27.2 ± 2.2 vs 32.8 ± 1 and 31.0 ± 2.5%; p < 0.01). AIxSphygmoCor® was lower in HIIPE than other times (23.2 ± 2.4 vs baseline 32.8 ± 1.9 p < 0.01; vs MICPE 27.2 ± 2.2; p = 0.039; vs 24 hours MICPE 31.0 ± 2.5; p < 0.01 and vs 24 hours HIIPE 32.2 ± 2.0%; p < 0.01). AIxArteriograph® was lower in HIIPE (16.0 ± 3.7%) than baseline (28.9 ± 3.4%; p = 0.001), 24 hours MICPE (25.7 ± 4.0%; p = 0.008) and 24 hours HIIPE (29.5 ± 3.9%; p = 0.005). ΔAIxHIIPE was greater than ΔAIxMICPE (−9.37 vs −5.15; p = 0.028). AIxArteriograph® showed a positive correlation with AIxSphygmoCor® (r = 0.793; p < 0.01) and showed agreement.
Conclusion
Regardless of intensity, one exercise session improves AIx. The effect seems to be greater after HIIPE than MICPE.
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