Effects of Race and Gender Classifications on Atherosclerotic Cardiovascular Disease Risk Estimates for Clinical Decision-Making in a Cohort of Black Transgender Women - PubMed

doi: 10.1089/heq.2023.0066. eCollection 2023.

Elle Lett  ^{2   3   4} , Ashleigh J Rich  ¹ , Huijun Jiang  ⁵ , Andrea L Wirtz  ⁶ , Asa Radix  ⁷ , Sari L Reisner  ^{8   9   10   11} , Alexander B Harris  ⁷ , Jowanna Malone  ¹² , William G La Cava  ^{2   13} , Catherine R Lesko  ⁶ , Kenneth H Mayer  ^{9   11   14} , Carl G Streed Jr  ^{11   15   16}

Introduction: Despite their dynamic, socially constructed, and imprecise nature, both race and gender are included in common risk calculators used for clinical decision-making about statin therapy for atherosclerotic cardiovascular disease (ASCVD) prevention.

Methods and materials: We assessed the effect of manipulating six different race-gender categories on ASCVD risk scores among 90 Black transgender women.

Results: Risk scores varied by operationalization of race and gender and affected the proportion for whom statins were recommended.

Discussion: Race and gender are social constructs underpinning racialized and gendered health inequities. Their rote use in ASCVD risk calculators may reinforce and perpetuate existing inequities.

1. 1. Centers for Disease Control and Prevention. Leading Causes of Death. 2022. Available from: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm [Last accessed: February 27, 2023].
2. 1. Javed Z, Haisum Maqsood M, Yahya T, et al. . Race, racism, and cardiovascular health: Applying a social determinants of health framework to racial/ethnic disparities in cardiovascular disease. Circulation 2022;15(1):e007917; doi: 10.1161/CIRCOUTCOMES.121.007917. - DOI - PubMed
3. 1. Gao Z, Chen Z, Sun A, et al. . Gender differences in cardiovascular disease. Med Novel Technol Dev 2019;4:100025; doi: 10.1016/j.medntd.2019.100025. - DOI
4. 1. Beach LB, Streed CG Jr. Beyond sex-based medicine in cardiovascular health research and practice. Circulation 2023;147(7):529–531; doi: 10.1161/circulationaha.122.063156. - DOI - PMC - PubMed
5. 1. Streed CG Jr., Beach LB, Caceres BA, et al. . Assessing and addressing cardiovascular health in people who are transgender and gender diverse: A scientific statement from the American Heart Association. Circulation 2021;144(6):e136–e148; doi: 10.1161/cir.0000000000001003. - DOI - PMC - PubMed