BP Monitoring Should Be Routine Following Gender-Affirming Hormone Therapy

Routine blood pressure monitoring should be conducted in individuals undergoing gender-affirming hormone therapy (GAHT), which is associated with blood pressure changes, according to a recent study.¹

In order to further explore this relationship, the researchers conducted the largest and longest to-date observational study on the subject, including blood pressure readings from 470 transgender and gender-diverse adult patients in Washington DC. All participants underwent blood pressure measuring at baseline and at follow-up visits up to 57 months after the start of GAHT.

Overall, the researchers found that within 2 to 4 months of GAHT initiation, mean systolic blood pressure was lower in the transfeminine group by 4.0 mm Hg and higher in the transmasculine group by 2.6 mm Hg. The changes were present throughout the entirety of follow-up, and no changes in diastolic blood pressure were observed.

Further, stage 2 hypertension prevalence decreased in the transfeminine group by 47% (from 19% to 10%) within 2 to 4 months of GAHT. The researchers also noted that the use of testosterone in the transmasculine group could be associated with increased heart attack or stroke risk in individuals with untreated high blood pressure.

“Given the higher burden of heart attack, stroke and other cardiovascular conditions among transgender men and women, blood pressure screening and monitoring are important, especially after beginning hormone therapies,” they wrote in an accompanying press release.²

—Michael Potts

References:

1. Blood pressure effects of gender-affirming hormone therapy in transgender and gender-diverse adults. Published online April 19, 2021. Hypertension. https://doi.org/10.1161/HYPERTENSIONAHA.120.16839
2. Gender-affirming hormone therapy may increase risk of high blood pressure. News release. April 19, 2021. Dallas, Texas. https://newsroom.heart.org/news/gender-affirming-hormone-therapy-may-increase-risk-of-high-blood-pressure