Risultati per: Transgender – Competenze e ruoli del medico di medicina generale

In varie città. Anche una guida informativa ed un portale

Circulation, Volume 150, Issue Suppl_1, Page A4140679-A4140679, November 12, 2024. Introduction:Transgender and gender diverse (TGD) adults have disproportionately greater burden of cardiovascular disease (CVD) risk. However, prevalent and incident heart failure (HF) and its risk factors have not been well-characterized in TGD populations.Objective:To determine the prevalence and incidence of HF risk factors and phenotype by gender identity.Methods:The study included commercial insurance claims data for 408,457 adults from 2006-2022. Gender identity was classified as cisgender male, cisgender female, transmasculine, transfeminine, or unclassified TGD identity. HF risk factors and phenotype (i.e., HFrEF, HFpEF, other HF) were abstracted using administrative billing codes. Multivariate logistic regression and Cox proportional hazard models examined associations between gender identity and prevalent and incident HF, respectively. Models were stratified by HF phenotype and adjusted for clinical comorbidities and presence of CVD.Results:Of 57,471 TGD patients, 9,652 (16.8%) were transfeminine, 17,898 (31.1%) were transmasculine, and 29,921 (52.1%) had unclassified TGD identity. The mean age was 35±16 years, followed for 5.5±4.7 years. The prevalence of HF risk factors differed by gender identity (Table 1). Among TGD adults the overall prevalence of HFrEF, HFpEF, and other HF were 0.4% (n=204), 0.4% (n=222), and 1.8% (n=1,015), respectively. Prevalent HF differed by gender identity (p

Circulation, Volume 150, Issue Suppl_1, Page A4145315-A4145315, November 12, 2024. BACKGROUND:Transgender and gender expansive (TGE) people constitute a vulnerable population with added cardiovascular risk and frequently experience health inequalities and obstacles to care. However, they are nonetheless underreported and underrepresented in clinical trials. We aim to understand inclusion and representation of TGE population in clinical research by examining the volume and caliber of reporting in certain disciplines of CV clinical trials.METHODS:A systematic review of clinical trials from January 2020 to March 2024 was conducted across 4 cardiovascular areas (heart failure, stroke, dyslipidemia, electrophysiology) using ClinicalTrials.gov focusing on the inclusion and reporting of TGE populations in the United States with published results. Trials were evaluated for explicit mention of TGE participants, use of gender-inclusive language, and provision of disaggregated data by gender identity. Equity metrics, such as the proportion of trials including TGE participants were calculated.RESULTS:A total of 32,583 participants were included(Table).We collected reporting of populations for sex and gender descriptions, as well as the inclusion and exclusion criteria. Almost all studies reported sex or gender as a single outcome variable. We inferred this to denote sex unless it was specified otherwise. All studies reported sex, with women representing 54% of all participants. Women represented the minority of study participants in stroke (39%), dyslipidemia (45%), and electrophysiology (37%) clinical trials, but majority of participants in heart failure trials (64%). Gender identity, including the option “other”, was reported in only 3 trials (4.1%), of which 2 were heart failure and 1 was a dyslipidemia trial. Most trials had pregnant women, lactating women, and age 18 years as the inclusion criteria.CONCLUSION:Our findings confirm that there is still a lack of commitment in current clinical trials to the Sex and Gender Equity in Research guidelines. The impact of the differences in this population can never be fully understood unless gender identification data is carefully gathered. Current national guidelines mandate that in randomized clinical trials, gender should be fully reported and that gender-inclusive language be used appropriately. To properly represent and care for these populations, future cardiology studies should adhere to the Sex and Gender Equity in Research principles.

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