Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

Gogia, Shawnbir; Coromilas, Alexandra; Regan, Susan; Stone, Lauren; Fourman, Lindsay T; Triant, Virginia A.; Neilan, Tomas G.; Zanni, Markella V.

doi:10.1097/qai.0000000000001767

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…One of the only other existing studies exploring CVD among TW (n = 23) and CM (n = 92) living with HIV found elevated levels of anemia, depression, HCV infection, and poor HIV control [35]. Many of the traditional CVD risk factors measured in the study were not different among TW and CM.…”

Section: Plos Onementioning

confidence: 55%

Cardiovascular disease risk among transgender women living with HIV in the United States

et al. 2020

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Background Transgender women (TW) are disproportionately affected by both HIV and cardiovascular disease (CVD). Objectives We aim to quantify prevalence of elevated predicted CVD risk for TW compared to cisgender women (CW) and cisgender men (CM) in HIV care and describe the impact of multiple operationalizations of CVD risk score calculations for TW. Design We conducted a cross-sectional analysis of patients engaged in HIV care between October 2014 and February 2018.

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Section: Plos Onementioning

confidence: 55%

Cardiovascular disease risk among transgender women living with HIV in the United States

et al. 2020

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“…One study examined the incidence of coronary risk factors in transgendered females compared to a cisgendered male control group and found that there were no difference in the incidence of cardiovascular risk factors between the groups. 68 They did, however, note that the transgendered female group did have suboptimal HIV control. This heightened immune activation may be a mechanism by which accelerated cardiovascular disease can occur.…”

Section: Cardiovascular Risks and Exogenous Sex Steroids Therapy (Hrt)mentioning

confidence: 98%

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

Seal

2019

JRSM Cardiovascular Disease

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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 17b oestradiol that is used in modern practice.

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“…16,17 None of these studies addressed potential confounding nontraditional cardiovascular risk factors such as HIV and minority stressors that are prevalent among transfeminine persons. 21,22 Conversely, a recent multicenter prospective study with a 2-year follow-up found that feminizing GAHT induced a favorable change in the lipid profile without significantly affecting the Framingham 30-year cardiovascular disease risk. 23 Another study found an association between feminizing GAHT use and decreased blood pressure with significant decrease in the prevalence of stage 2 hypertension within 2 to 4 months of GAHT initiation.…”

Section: Feminizing Hormonesmentioning

confidence: 99%

“…Smoking was prevalent within the studied TGD populations and was common among those who developed adverse cardiovascular events 16,17. None of these studies addressed potential confounding nontraditional cardiovascular risk factors such as HIV and minority stressors that are prevalent among transfeminine persons 21,22…”

Section: Cardiovascular Diseasementioning

confidence: 99%

What Cardiothoracic Radiologists Should Know About Imaging in Transgender Patients

Carroll

Massoth

Stowell

2022

Journal of Thoracic Imaging

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Transgender and gender diverse (TGD) individuals may undergo a wide range of care during gender transition including mental health counseling, gender-affirming hormonal therapy, and various surgeries. Hormone therapy effectively converts the hormonal milieu into that of the affirmed gender and produces measurable alterations in serum markers for coronary artery disease and other hematologic conditions (eg, erythrocytosis, venous thrombosis). Although illegal in the United States, some transgender women may receive silicone injections for breast and soft tissue augmentation, which can lead to devastating local complications, as well as silicone migration, pulmonary embolism, systemic reactions, and death. Smoking rates are higher among transgender and sexual minority populations, placing them at elevated risk of smokingrelated diseases, including lung cancer. Some opportunistic infections may be more common in the TGD populations, attributable to higher rates of coexisting infection with human immunodeficiency virus. Radiologists should be aware that these patients may develop cancer of their natal organs (eg, breast, prostate), especially as some of these tissues are not completely removed during gender-affirming surgery, which may manifest with thoracic involvement by secondary neoplasia. As more TGD patients seek medical care, thoracic radiologists can reasonably expect to interpret imaging performed in this population and should be aware of possible disease processes and potential complications of hormonal and surgical therapies.

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Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

Cited by 13 publications

References 18 publications

Cardiovascular disease risk among transgender women living with HIV in the United States

Cardiovascular disease risk among transgender women living with HIV in the United States

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

What Cardiothoracic Radiologists Should Know About Imaging in Transgender Patients

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