Cardiovascular health research on transgender and gender diverse (TGD) persons is severely lacking. To underscore this need, organizations like the American Heart Association have highlighted that improvements in heart-related clinical management are contingent on the production of research specific to transgender persons.
At Stony Brook Heart Institute, Smadar Kort, MD, Puja B. Parikh, MD, MPH, and the research team have prioritized addressing some of the fundamental gaps in cardiovascular TGD health, publishing an article in the journal Critical Pathways in Cardiology, titled, Prevalence and Predictors of Cardiovascular Disease and Risk Factors in Transgender Persons in the United States.
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The study sought to characterize the prevalence and predictors of cardiovascular disease (CVD) in transgender women, transgender men and gender nonconforming persons using a self-identified cohort from the 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey.
“Cardiovascular disease was widely prevalent in people who identified themselves as transgender, and was associated with various risk factors,” said Dr. Kort. “Allowing people who participate in clinical research to identify their gender in a non-binary fashion would enhance our ability to better understand the health issues transgender individuals may have.”
Key Study Findings
A total of 1,019 individuals identified as TGD. Among those individuals, 37.1% identified their transition status as male-to-female, 38.7% as female-to-male, and the remaining 24.2% as gender nonconforming. A total of 13.5% had reported CVD, which was operationalized as an affirmative answer to a healthcare professional telling the individual that they had any of the following: heart attack or myocardial infarction, angina or coronary heart disease, or stroke. The remaining 86.5% of TGD persons did not report CVD. Similar patterns were reported in the prevalence of CVD in TGD persons who identified as male-to-female, female-to-male, and gender nonconforming (14.6% vs. 13.5% vs. 12.1%; P = 0.69). In terms of predictors for CVD, TGD persons with CVD were older with lower annual income. Behavioral predictors were higher rates of smoking, lower rates of regular exercise, and higher rates of chronic medical comorbidities. Independent predictors of CVD in TGD persons included older age, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, and depressive disorder.
Based on the authors' findings, interventions to reduce the risk for cardiovascular risk are warranted, including enhanced access to medical care for this population. “Continued cardiovascular health research that is inclusive of transgender and gender diverse individuals is needed in order to better understand health priorities and, importantly, to improve outcomes among this population," said Dr. Parikh.
Dr. Kort and Dr. Parikh are both cardiac specialists at Stony Brook Heart Institute. Dr. Kort is a Professor of Medicine, Renaissance School of Medicine at Stony Brook University, and the Director of Non-Invasive Cardiovascular Imaging as well as the Co-Director of the Valve Center. Dr. Parikh is an Associate Professor, Renaissance School of Medicine at Stony Brook University, an interventional cardiologist as well as the Director of the Transcatheter Aortic Valve Replacement (TAVR) Program. As the premiere hospital in the region, Stony Brook Heart Institute excels at treating the most complex heart conditions. The Heart Institute’s cardiac specialists are often among the first to offer important state-of-the-art treatment options with results that match or exceed the nation’s best outcomes.