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Transgender patients more likely to suffer heart attacks, medical school residents find

Medical school resident Tran Nguyen co-authored the study.

Updated: April 12, 2019 at 4:53 a.m.

Two residents in the School of Medicine and Health Sciences published a study last week finding that transgender individuals face a higher risk of heart attack.

A team of 11 researchers found that transgender men are four times more likely to suffer a heart attack than cisgender men and women, and transgender women are twice as likely to have a heart attack than cisgender women, according to the study. Researchers found that factors like limited access to health care, low exercise levels and health conditions like high blood pressure in the transgender community contribute to the increased risk – but they said the findings could inspire future research to help health care providers and transgender patients better work together to mitigate risk factors.

“In the health care community, we should be more equipped to take care of transgender patients and make them feel welcome in the clinic,” Tran Nguyen, a medical school resident and a co-author of the study, said. “You create an environment so that they can come to us and seek the care they need help with.”

The authors of the study used SAS 9.4, a data analysis software program, to examine data on health-related risk behaviors – like smoking and low exercise levels – in transgender populations. They also evaluated information about chronic health conditions from the Behavioral Risk Factor Surveillance System, a database operated by the Centers for Disease Control and Prevention, she said.

Nguyen said she and her colleagues researched the topic for about five to six months and finalized their results last month. She said the research team chose to investigate heart attack risk in transgender patients because there is limited research on cardiovascular health in the transgender community.

She said past studies have shown hormone replacement therapy could augment the risk of heart attacks because high estrogen and testosterone levels create inflammation and decrease good cholesterol levels. Increased inflammation causes blood vessels to tighten, which can lead to plaque buildup resulting in a heart attack, she said.

She said she would like to conduct further research to prove a definitive relationship between replacement therapy and increased heart attack risk.

Nguyen said transgender patients are often reluctant to seek treatment from health care professionals because they are “afraid” of being mistreated, which can be a “barrier” to receiving necessary care or medical advice.

Nguyen added that because the national transgender population is increasing, health care professionals must learn to accommodate the health care needs of transgender patients to decrease heart attack rates.

“We don’t have enough awareness or enough health care dedicated to this population,” she said.

The researchers said they did not require funding to complete the research, but the American Heart Association provided money to travel to research conferences and share their findings. They declined to say how much funding they received.

Talal Alzahrani, a cardiology fellow and another author of the study, said in an email that transgender patients could face a higher risk of heart attack than cisgender patients because of increased exposure to social stressors, a lack of access to adequate health care and lower socioeconomic status.

“Our study would likely raise the awareness among clinical providers and transgender population about the risk of heart attack to emphasize about the importance of primary coronary artery disease prevention in the transgender population,” he said.

Alzahrani added that he hopes the study will lead to further research on heart attack risk in transgender patients and encourage lawmakers to institute policies aimed at decreasing the number of instances of heart attacks.

Michael Irwig, an associate professor of medicine who specializes in transgender health care, said further research about heart attack risk in transgender patients will better equip health care professionals to identify and treat health conditions that cause heart attacks, like high blood pressure.

“The research will hopefully lead to improved management of risk factors which may reduce the risk for disease,” Irwig said in an email.

This post was updated to reflect the following corrections:

A previous version of this article referred to Talal Alzahrani by the wrong pronouns. The pronouns are now correct. The Hatchet also incorrectly reported that Alzahrani is a medical resident. He is a cardiology fellow. We regret these errors.

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