Many transgender people who take hormone therapy have unaddressed risks for heart disease and stroke, a new study finds.
These patients often have undiagnosed high blood pressure and high cholesterol, even in young adulthood, researchers found.
"Previous research has shown that transgender individuals are less likely to have access to health care or to utilize health care for a variety of reasons, including stigma and fear of mistreatment," said researcher Dr. Kara Denby, a clinical fellow in cardiovascular medicine at the Cleveland Clinic.
"Since transgender individuals have frequent physician visits while taking hormone therapy, this seems an opportune time to screen for cardiovascular risk factors and treat previously undiagnosed cardiovascular disease that can lead to poor health outcomes in the future," she added in a news release from the American Heart Association.
For the study, Denby's team looked at risk factors and medical history for more than 400 adults when they first sought care at the hospital's transgender program.
The researchers found that nearly 7% had undiagnosed high blood pressure, and 11% had undiagnosed high cholesterol.
Of those already known to have high blood pressure, more than one-third were not receiving recommended treatment. Of those already diagnosed with high cholesterol, more than three-quarters were not receiving treatment.
"When we calculated the risk for developing a heart attack or stroke over 10 years, the risk for transgender men and women was higher than that reported for the average American of their age and gender. We also found that even in the highest risk individuals, many were not receiving recommended treatment," Denby said.
The researchers also found that 56.5% of the patients had been diagnosed with a mental health disorder such as anxiety or depression, which is also tied to an increased risk of heart disease.
"Transgender individuals face numerous barriers and biases to access the health care they need. We owe it to them to improve access and care so they can improve their [cardiovascular] health and overall well-being. Policies and health care structures that are safe and supportive are critical for the transgender population to achieve health equity," Denby said.
The study results are scheduled for presentation Nov. 13-17 at a virtual meeting of the heart association.