Cardiovascular Events and Gender-Affirming Hormone Therapy, 10 Years of Follow-Up

Riveros Karla Mariaca; Veronica Martinez; Maria Claro; Clara Sola; Gloria Aranda; Hanzu Felicia Alexandra; Emilio Ortega; Aida Orois; Esther Gomez; Teresa Godas; Salat Manel Mateu; Irene Halperin; Mireia Mora

doi:10.1530/endoabs.90.P450

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Endocrine Abstracts (2023) 90 P450 | DOI: 10.1530/endoabs.90.P450

ECE2023 Poster Presentations Reproductive and Developmental Endocrinology (108 abstracts)

Cardiovascular Events and Gender-Affirming Hormone Therapy, 10 Years of Follow-Up

Karla Mariaca Riveros ¹ , Veronica Martinez ² , Maria Claro ¹ , Clara Solá ¹ , Gloria Aranda ² , Felicia Alexandra Hanzu ¹ , Emilio Ortega ¹ , Aida Orois ¹ , Esther Gomez ² , Teresa Godas ² , Manel Mateu Salat ¹ , Irene Halperin ¹ & Mireia Mora ¹

Err

Author affiliations

¹Hospital Clínic de Barcelona, Endocrinology and Nutrition, Barcelona, Spain; ²Hospital Clínic de Barcelona, Barcelona, Spain

Objectives: Most transgender persons (0.3-0.5% of total population) are under gender-affirming hormone therapy (GAHT). Several studies have reported an increased morbimortality due to cardiovascular events (CVE), infectious disease and suicide. However, these studies were made on small populations and short follow up. We evaluated the changes on anthropometric variables, risk factors for cardiovascular diseases (CVD) and CVE at 5 and 10 years of follow up in a transgender population followed in a Gender Identity Unit in Catalonia.

Methods: Retrospective longitudinal study including transgender people visited at the Hospital Clinic of Barcelona between 2006 and 2010. Anthropometric variables, analytical parameters, clinical data on hypertension, diabetes, dyslipidemia, thrombotic events (deep venous thrombosis (DVP) and pulmonary embolism), cerebrovascular events (stroke or transient vascular accident) and ischemic heart disease (heart attack, stable and unstable angina) were collected at baseline, 5 and 10 years together with the GAHT schedule. The events were compared with the Spanish ciswomen and cismen population age adjusted.

Results: 248 transgender people were included, 60.9% transwomen (32.6±10.0y) and 39.1% transmen (28.8±8.4y). At 5- and 10- years follow-up body mass index, total cholesterol and LDL levels increased in both transmen and transwomen as well as triglycerides in transmen; P<0.01. Hypertension increased in transwomen and transmen at 10 years (P<0.01 and P=0.02, respectively). During follow-up, two DVTs, two ischemic events, and two strokes were reported in transwomen, with an incidence rate of 0.33 %-year (ciswomen, age range 27-60: 0.22%-year; cismen, age range 27-60: 0.36 %-year); one DVT was reported in transmen, an incidence rate of 0.10%- year (cismen, age range 27-35: 0.07 %-year; ciswomen, age range 27-35: 0.05%-year). Obesity was associated to cyproterone acetate in transwoman; and hypertension and dyslipidemia were associated to testosterone treatment. No person died.

Conclusion: These data suggest that there is a small increased risk of CVE in transwomen in comparison to ciswomen and no difference with cismen. In transmen, small increased risk of CVE in comparison to ciswomen was observed. However, no association was found with the regimen of GATH and low number of events and small population should be considered. Toxic habits are highly prevalent in our population (42% of transwomen and 60 % transmen in comparison with 16.4% of ciswomen and 23.3% of cismen in Spanish population). Recommendation of healthy lifestyle habits should be made. There are no previous data regarding CVE at 10 years of follow up in Spanish trans population.