Abstract
Background: As of 2016, approximately 1.4 millions persons in the United States identify as transgender. Despite their growing number and increasing specific medical needs, there has been lack of research regarding cardiovascular disease (CVD) and CVD risk factors in this population. Recent studies have showed that transgender population had a significant higher rate CVD risk factors without a significant increase in overall CVD morbidity and mortality. These studies are limited by their small sample sizes and their predominant focus on younger transgender populations. With larger sample size and inclusion of broader age range, our study aims to provide more insights into the association between being transgender and cardiovascular risk factors, as well as, myocardial infarction (MI). Methods: The 2017 Behavioral Risk Factor Surveillance System (BRFSS) data was used to evaluate the correlation between being transgender and the rate of myocardial infarction (MI) and CVD risk factors. Logistic regression model was constructed to study the association between being transgender and rate of myocardial infarction after adjusting for CVD risk factors including age, diabetes, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise. Analyses were performed using SAS, version 9.4 and accounted for the complex survey design of BRFSS. Results: The weighted frequency of transgender men and transgender women in our cohort were 354,048 (0.46%) and 437,886 (0.61%), respectively. Multivariable analysis revealed that transgender men had more than seven-fold increase in the rate of MI (OR=7.39, 95% CI=2.95, 18.55, p<0.001) compared to cisgender women while transgender women did not have significant increase in the rate of MI (OR=1.54, 95% CI=0.95, 2.51, p=0.081) compared to cisgender men after adjusting for age, diabetes, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise. Conclusion: Transgender men are at higher rate of MI compared to cisgender women after adjusting for CVD risk factors.
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