Mount Sinai Center for Transgender Medicine, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York.
Mount Sinai Center for Transgender Medicine, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York.
Endocr Pract. 2021 Jan;27(1):63-70. doi: 10.1016/j.eprac.2020.11.001. Epub 2020 Dec 13.
To review screening guidelines for cardiometabolic disease in aging patients and review literature describing the effect of hormone therapy (HT) on several key cardiometabolic processes to inform providers caring for older transgender individuals.
A traditional literature review was performed using PubMed and Google Scholar databases.
The risk of cardiovascular disease increases with age. Exogenous sex hormones may interact with hormone-dependent metabolic pathways and affect some biochemical assays, but they do not necessarily impact clinical outcomes. While long-term HT is associated with an increased risk of some adverse cardiovascular outcomes, modern treatment regimens minimize this risk.
Screening for cardiometabolic derangements and risk reduction are important for all aging individuals. Currently, there is insufficient evidence to propose separate screening recommendations for transgender individuals on long-term HT. Aging transgender men and women should be monitored for cardiovascular disease in much the same way as their cisgender counterparts.
回顾老年患者中心血管代谢疾病的筛查指南,并回顾描述激素治疗(HT)对几种关键心血管代谢过程影响的文献,为治疗老年跨性别个体的医护人员提供信息。
使用 PubMed 和 Google Scholar 数据库进行传统文献回顾。
心血管疾病的风险随年龄增长而增加。外源性性激素可能与激素依赖性代谢途径相互作用,并影响某些生化检测,但它们不一定影响临床结局。虽然长期 HT 与某些不良心血管结局的风险增加有关,但现代治疗方案可将这种风险降至最低。
筛查心血管代谢紊乱和降低风险对所有老年人都很重要。目前,尚无足够证据提出针对长期 HT 的跨性别个体的单独筛查建议。应像对待顺性别同龄人一样,对接受长期 HT 的老年跨性别男性和女性进行心血管疾病监测。