LGBTQ+ Health Updates

LGBTQ+ Health Updates

Disclosures: The authors report no relevant financial disclosures.
April 19, 2021
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Gender-affirming hormone therapy tied to changes in BP

Disclosures: The authors report no relevant financial disclosures.
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Gender-affirming hormone therapy may cause a decrease in mean systolic BP in transgender women and an increase in mean systolic BP in transgender men, researchers reported.

Michael Irwig

“There are many important gaps in our knowledge about the effects of hormone therapy for transgender people. This study examined the time course and magnitude of the effects of gender-affirming hormones on blood pressure,” Michael Irwig, MD, associate professor of medicine at Harvard Medical School and director of transgender medicine at Beth Israel Deaconess Medical Center in Boston, said in a press release.

Gender-affirming hormone therapy and BP
Systolic BP dropped in transgender women and rose in transgender men 2 to 4 months after starting gender-affirming HT, with no impact observed on diastolic BP. Data were derived from Banks K, et al. Hypertension. 2021;doi:10.1161/HYPERTENSIONAHA.120.16839.

Researchers measured the BP of 470 patients aged 17 years or older before they started gender-affirming hormone therapy and at visits after therapy was initiated up to a maximum of 57 months.

“Given that gender-diverse people have a higher burden of cardiovascular disease and hypertension than cisgender people, identifying individuals with hypertension is important so that treatment can be initiated to modify this important risk factor,” Katherine Banks, MD, resident physician at the Hospital of the University of Pennsylvania, and colleagues wrote.

According to the researchers, within 2 to 4 months of beginning hormone therapy, systolic BP was lower in transgender women (P < .0001) and higher in transgender men (P < .05).

For the transgender women group, the mean systolic BP decreased by 4 mm Hg at 2 to 4 months and 6 mm Hg at 11 to 21 months, according to the researchers.

In transgender men, mean systolic BP increased by 2.6 mm Hg at 2 to 4 months and 2.9 mm Hg at 11 to 21 months, the researchers wrote.

In the analysis, the decrease in systolic BP in transgender women and increase in systolic BP in transgender men occurred across white, Black and Latino/Latina patients.

According to the researchers, there were no statistically significant changes to diastolic BP for either group.

In transgender women, the percentage with stage 2 hypertension declined from 19% to 10% at 2 to 4 months after beginning hormone therapy.

Among transgender men, the percentage with stage 2 hypertension was similar, but the percentage with stage 1 hypertension was higher after 11 months of hormone therapy.

“The results of this study and others can be used to inform BP monitoring recommendations in the various treatment guidelines for transgender and gender-diverse patients,” the researchers wrote.