Clinical Scorecard: Inclusion of LGBTQIA+ Patients in Cardiovascular Disease Clinical Guidelines
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Inclusion of LGBTQIA+ Patients in Cardiovascular Disease Clinical Guidelines
Key Mechanisms
Mechanisms or clinical associations described in the source article.
Target Population
Population described in the source article.
Care Setting
Cardiology guideline development and clinical care; the review also discusses the 2024 KDIGO chronic kidney disease guideline.
Key Highlights
A review of 313 cardiology guidelines published in the 10 years before August 8, 2024, found that six (1.9%) included at least one searched LGBTQIA+-related term.
Two transplant-related guidelines mentioned men who have sex with men only in the context of donor screening and HIV transmission risk.
The 2023 chronic coronary disease guideline identified sexual orientation as a social determinant of health and called for research on cardiovascular risk in hormone-treated transgender women with chronic coronary disease.
The 2023 atrial fibrillation guideline stated that guideline-directed stroke-risk reduction therapies should be offered equitably regardless of sex and gender diversity.
The article reports associations between certain LGBTQIA+ subgroups and higher BMI, elevated HbA1c, and greater smoking incidence.
Guideline-Based Recommendations
Diagnosis
Management
The 2023 atrial fibrillation guideline states that patients should be equitably offered guideline-directed therapies for stroke-risk reduction, irrespective of sex and gender diversity.
The 2024 KDIGO guideline recognizes an urgent need to build transgender cultural safety across kidney disease management and care.
Monitoring & Follow-up
The 2024 KDIGO guideline notes that exogenous hormone use, including gender-affirming hormone therapy, may affect kidney-health measures.
The 2023 chronic coronary disease guideline calls for research on cardiovascular risk among hormone-treated transgender women with prevalent chronic coronary disease.
Risks
The article reports that research has associated certain LGBTQIA+ subgroups with higher BMI, elevated HbA1c, and greater smoking incidence.
The article states that psychosocial stressors and structural inequities may predispose LGBTQIA+ individuals to cardiac risk factors.
Patient & Prescribing Data
LGBTQIA+ people; the article notes that this community constituted 7% of the U.S. population in 2023.
The article does not provide prescribing data. It reports that the atrial fibrillation guideline supports equitable offering of guideline-directed stroke-risk reduction therapies regardless of sex and gender diversity, and that cardiovascular implications of gender-affirming hormone therapy remain insufficiently addressed.
Clinical Best Practices
The 2023 atrial fibrillation guideline states that guideline-directed therapies for stroke-risk reduction should be offered equitably, irrespective of sex and gender diversity.
The 2024 KDIGO guideline notes that exogenous hormone use may affect kidney-health measures.
The 2023 chronic coronary disease guideline calls for further research on cardiovascular risk among hormone-treated transgender women with prevalent chronic coronary disease.
Coronary artery disease develops when plaque accumulates within the arteries that supply blood to the heart muscle. Genetics can play an important role, while smoking, diabetes, uncontrolled high blood pressure, inactivity, poor diet and other factors can accelerate the process.
