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Cardiovascular Disease in a Population-Based Sample of Transgender and Cisgender Adults – Carolina Center for Population Aging and Health

Cardiovascular Disease in a Population-Based Sample of Transgender and Cisgender Adults


Poteat, Tonia; Divsalar, Shahrad; Streed, Carl G. Jr.; Feldman, Jamie; Bockting, Walter; & Meyer, Ilan H. (2021). Cardiovascular Disease in a Population-Based Sample of Transgender and Cisgender Adults. American Journal of Preventive Medicine, 61(6), 804-811. PMCID: PMC8608688


Introduction: Existing data on cardiovascular disease (CVD) among transgender people are inconsistent and derived from non-representative samples or population-based data sets that do not include transgender-specific risk factors such as gender affirming hormone use and gender minority stressors. A nationally representative sample of cisgender and transgender adults age 40 years and older was used to assesses prevalence and correlates of smoking, select CVD conditions, and venous thromboembolism (VTE).
Methods: Participants were recruited from 2016-2018, with analysis conducted in December 2020 with 114 transgender and 964 cisgender individuals. Sample weights and multiple imputation were used for all estimates except descriptive statistics. Logistic regression models estimated odds ratios and 95% confidence intervals expressing the relationship between each outcome variable and a set of independent variables. Each model controlled for race and age.
Results: No meaningful differences between cisgender and transgender participants were found in smoking or CVD conditions. However, there was an increased odds of VTE among transgender women compared to cisgender women. Transgender people had a greater odds of discrimination, psychological distress, and adverse childhood experiences. These stressors were associated with increased odds of a CVD condition; and everyday discrimination and adverse childhood experiences were associated with increased odds of smoking. Discrimination and psychological distress were associated with VTE.
Conclusion: Transgender people face disparities in CVD risk. This study provides support for the gender minority stress model as a framework for understanding CVD disparities. Future research with larger samples and adjudicated outcomes are needed to advance the field.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Preventive Medicine


Poteat, Tonia
Divsalar, Shahrad
Streed, Carl G. Jr.
Feldman, Jamie
Bockting, Walter
Meyer, Ilan H.

Article Type




Data Set/Study

TransPop Study


United States of America




Transgender Women
Transgender Men


Poteat - 0000-0001-6541-3787