Abstract 14236: Cardiovascular Risk at Presentation for Gender-Affirming Care in the Transgender Population

Abstract

Introduction: Due to stigma, the transgender (TG) population experiences socioeconomic and health disparities, including decreased access to care. Use of gender affirming hormone therapy (GAHT) may place TG individuals at increased cardiovascular (CV) risk. The objective of this study is to identify the baseline CV risk of TG individuals presenting for gender affirming care. Methods: This was a retrospective study of TG patients seeking GAHT from a multi-disciplinary transgender program. Patients were included if they had not yet initiated GAHT. Once patients were identified, the EMR was queried for the following data: demographics, medical history, vitals, medications, and laboratory results. The ACC/AHA ASCVD and QRISK3 risk scores were calculated for all patients who did not have documented CV disease. Results: 427 patients met inclusion criteria. Demographics are in Table 1. Of the patients, 237 (55.4%) had a chronic medical condition. The incidence of undiagnosed hypertension and hyperlipidemia was 6.8% and11.3% respectively, and of these cases, only 64.4% and 24.1% were on appropriate therapies. Mean ASCVD risk and QRISK3 for ages 40-65 was 8.3% and 12.2%, respectively. Mean QRISK for ages 25-39 years was 4.6%. Of those patients who fell into intermediate or high risk categories, there was limited statin use (Figure 1). Conclusions: TG individuals presenting for GAHT have elevated CV risk, including high rates of undiagnosed and untreated CV risk factors with inadequate CV prevention. They appear to be at higher risk than their age matched historical cohorts regardless of gender.