Does gender-affirming hormone therapy affect BP of transgenders?
06 Feb 2021
Doctors and therapists are said to be failing transgender patients due to their lack of knowledge and expertise in the area.The impact of gender-affirming hormone therapy (GHT) on blood pressure (BP) in transgender individuals remains unclear, as shown by data from a systematic review.
The investigators searched the databases of PubMed/Medline, Scopus, and Cochrane Library for articles published relating to the BP of transgender adults on GHT. They evaluated the methodological quality using the Quality Assessment Tool for Before–After (Pre–Post) Studies with No Control Group.
A total of 600 articles were screened, of which 14 met the eligibility criteria, including 1,309 individuals (approximately 50 percent transgender men [mean age, 23.0–36.7 years] and women[mean age, 25.2_34.8 years]) treated with GHT between 1989 and 2019.
The articles included were all pre–post observational studies with no control groups. Interventions were diverse and included oral, transdermal, and injectable hormonal preparations with follow-up of 4 months to 5 years.
In studies involving transgender men on GHT, no change in BP was observed. On the other hand, studies on transgender women taking GHT showed both increases and decreases in systolic BP. The studies were heterogenous with significant methodological limitations. Of note, only two were found to be of good quality.
“Better quality research is essential to elucidate whether exogenous sex hormones modulate BP in transgender people and whether this putative alteration infers poorer cardiovascular outcomes,” the investigators said.
GHT is used by transgender people to align their secondary sex characteristics with their gender identity. Data regarding its cardiovascular outcomes in this population are lacking, according to the investigators.