{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:48:18Z","timestamp":1791679698406,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transgender and gender diverse (TGD) individuals represent a growing population with specific cardiovascular health needs. Current cardiovascular prevention strategies are largely derived from cisgender populations and may not adequately account for the combined effects of gender-affirming hormone therapy (GAHT) and other determinants. This expert opinion summarizes current evidence regarding cardiovascular health in TGD individuals, focusing on the cardiovascular effects of GAHT, population-specific cardiovascular risk factors, practical approaches to cardiovascular risk assessment, and future research priorities.<\/jats:p>\n                  <jats:p>Available evidence indicates that GAHT is associated with changes in cardiometabolic risk factors, haemostasis, vascular function, and cardiac physiology. Feminizing GAHT is associated with an increased risk of venous thromboembolism, whereas masculinizing GAHT is associated with adverse lipid changes, erythrocytosis, and a potentially increased risk of major cardiovascular events. However, causal inference is limited by the predominance of observational studies, relatively young study populations, heterogeneous GAHT regimens, short follow-up, and the absence of randomized study evidence. Population-level cardiovascular disparities in TGD should not be attributed to GAHT alone and smoking, obesity, physical inactivity, minority stress, socioeconomic disadvantage, and unequal access to healthcare may independently or interactively influence cardiovascular risk. Current cardiovascular risk prediction tools have not been validated or calibrated in TGD populations and do not account for GAHT exposure or TGD-specific psychosocial and structural determinants. Cardiovascular risk assessment in TGD individuals should integrate conventional risk factors, transgender-related cardiovascular risk factors, and patient involvement regarding individual goals.<\/jats:p>\n                  <jats:p>A coordinated multidisciplinary approach may facilitate personalized cardiovascular prevention while supporting access to gender-affirming care. Future research should prioritize long-term prospective studies and development of risk prediction models tailored to TGD populations.<\/jats:p>","DOI":"10.1093\/eurjpc\/zwag528","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:44:00Z","timestamp":1791459840000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular health in transgender and gender diverse individuals: an expert opinion on gender-affirming hormone therapy, risk assessment and clinical management"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2395-4977","authenticated-orcid":false,"given":"Marco","family":"Vecchiato","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Padova , Via Giustiniani 2, 35128 Padova ,","place":["Italy"]},{"name":"Department of Theoretical and Applied Sciences, eCampus University , Novedrate, 22060 Como ,","place":["Italy"]},{"name":"Sports Medicine and Cardiovascular Rehabilitation Unit, ULSS3 Serenissima , Noale, 30033 Venice ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3757-0261","authenticated-orcid":false,"given":"Lieve Mees","family":"van Zijverden","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Department of Endocrinology, Amsterdam UMC location Vrije Universiteit Amsterdam , De Boelelaan 1117, 1081HV, Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6941-1815","authenticated-orcid":false,"given":"Jason","family":"van Heesewijk","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Department of Endocrinology, Amsterdam UMC location Vrije Universiteit Amsterdam , De Boelelaan 1117, 1081HV, Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1960-537X","authenticated-orcid":false,"given":"Alberto","family":"Scala","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Padova , Via Giustiniani 2, 35128 Padova ,","place":["Italy"]},{"name":"Department of Systems Medicine, Unit of Andrology and Reproductive Medicine, University Hospital of Padova , Padova ,","place":["Italy"]},{"name":"Regional Reference Center for Gender Incongruence of the Veneto Region, University Hospital of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Biffi","sequence":"additional","affiliation":[{"name":"Medical Partner Scuderia Ferrari, Med-Ex, Medicine & Exercise , Roma-Maranello (MO), 00187 Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-3741","authenticated-orcid":false,"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Padova , Via Giustiniani 2, 35128 Padova ,","place":["Italy"]},{"name":"First Chair of Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, University Hospital of Padova , 35128 Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1744-9977","authenticated-orcid":false,"given":"Paul","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Diabetes, Queen Elizabeth University Hospital , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4736-9051","authenticated-orcid":false,"given":"Andrea","family":"Garolla","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Padova , Via Giustiniani 2, 35128 Padova ,","place":["Italy"]},{"name":"Department of Systems Medicine, Unit of Andrology and Reproductive Medicine, University Hospital of Padova , Padova ,","place":["Italy"]},{"name":"Regional Reference Center for Gender Incongruence of the Veneto Region, University Hospital of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-8256","authenticated-orcid":false,"given":"Sean J","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, University of Colorado Anschutz , 12801 E. 17 th Ave, Room 7103, Research 1 South, Aurora, Colorado, 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8872-5847","authenticated-orcid":false,"given":"Bethany A","family":"Jones","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Nottingham Trent University , Nottingham, NG1 4FQ ,","place":["England"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6838-4360","authenticated-orcid":false,"given":"Oleksii","family":"Korzh","sequence":"additional","affiliation":[{"name":"Department of General Practice - Family Medicine, Kharkiv National Medical University , Kharkiv ,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6996-8920","authenticated-orcid":false,"given":"Donata","family":"Kurpas","sequence":"additional","affiliation":[{"name":"Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University , ul. Kazimierza Bartla 5, 51-618 Wroc\u0142aw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-7183","authenticated-orcid":false,"given":"Panteleimon","family":"Papakonstantinou","sequence":"additional","affiliation":[{"name":"Atrial Fibrillation Institute, Heart and Vascular Centre and Cardiovascular Research Institute Dublin, Royal College of Surgeons of Ireland, Mater Private Hospital , 71 Eccles St, Dublin 7, D07 WKW8 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1558-4857","authenticated-orcid":false,"given":"Stefano","family":"Palermi","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine and Surgery - Unicamillus-Saint Camillus International University of Health Sciences , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0346-5412","authenticated-orcid":false,"given":"Sanne A E","family":"Peters","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University , Utrecht ,","place":["The Netherlands"]},{"name":"The George Institute for Global Health, School of Public Health, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7223-7574","authenticated-orcid":false,"given":"Elio","family":"Venturini","sequence":"additional","affiliation":[{"name":"Department of Cardiac Rehabilitation, Cecina Civil Hospital , Cecina (Livorno) ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-3430","authenticated-orcid":false,"given":"Maria","family":"Marketou","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete , 71500 Giofirakia, Heraklion, Crete ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-2340","authenticated-orcid":false,"given":"Justine","family":"Defreyne","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8338-8025","authenticated-orcid":false,"given":"Dorte","family":"Glintborg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Kl\u00f8verv\u00e6nget 6, 5th floor, University of Southern Denmark , DK-5000 Odense C ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,11]]},"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag528\/71838633\/zwag528.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag528\/71838633\/zwag528.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:01:15Z","timestamp":1791676875000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article\/doi\/10.1093\/eurjpc\/zwag528\/8907365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,11]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwag528","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,11]]},"article-number":"zwag528"}}