There have been previous studies examining the association between thyroid dysfunction and cardiovascular disease. Hypothyroidism is related to an increased risk of functional cardiovascular abnormalities, particularly for hypertension. The aim was to characterize the prevalence of hypothyroidism as a risk factor for arterial hypertension in a community-based study in San Luis, Argentina. Cross-sectional, retrospective and descriptive studies were designed. A total of 1,023 individuals were recorded at a cardiologic center (2006- 2008). Data abstracted from clinical history included: age, sex, hypertension (HTA >140/90 mm Hg), and serum thyroid function tests: TSH, T4 and T3. The investigation involved 698 patients with HTA (74.2% women), 367 with hypothyroidism (81.5% women) and 247 with hypothyroidism-HTA (79,8% women). Ages ranged from 22 to 92 years (mean: 49.9Â± 11.9) and mean weight 84.3Â±17.0 kg. Age was positively correlated with body weight (r=+ 0.312, P=0.003). TSH mean: 7.67Â±1.6 ÂµIU/ml (Men: 6.28Â±1.2 ÂµIU/ml, Women: 7.92Â±2.1 ÂµIU/ml). The mean systolic (SBP) and diastolic blood pressure (DBP) were 160.8Â±25.4 mm Hg and 98.8Â±13.9 mm Hg, respectively. Increasing SBP-DBP for range of TSH was studied. The positive association between TSH and SBP (r:+0.155,P=0.042) were found. The association between age (four categories) versus SBP in hypothyroidism patients (r=+0.267, P=0.0001) and the highest percentage was in the age range 51-60 years. DBP was also positively associated with age (r=+0.200, P= 0.0001), highest percentage in age range 41-50 years. There was an important increase in SBP (160.75Â±19.39-175.43Â± 21.00 mmHg) and TSH (3.71Â±2.05-12.06Â±9.23 ÂµUI/mL) in hypothyroid patients by age. DBP was highest in the 4th decade (104.70Â±11.87 mmHg). The positive association between TSH hypothyroidism-HTA and age were found (r:+0.353,P=0.0001). Serum T4 (7.78Â±2.40-6.75Â±2.15 Âµgr/dL) and T3 (1.24Â±0.35-0.88Â±0.26 ng/mL) decreased with age. High prevalence of hypothyroidism in our hypertensive patients was detected (20.8% and 5.6% subclinical). Decrease of serum T4 and T3 suggest the lack of blood pressure regulation which could be responsible for the hypertensive state. We found a positive association between TSH and SBP that could have implications for cardiovascular health. These findings indicate that hypothyroidism may be an important predictor of higher mean SBP. In conclusion, in these population patients we found a close association between hypertension and hypothyroidism.
hypertension, hypothyroidism, blood pressure, thyroid hormones
- Klein I, Danzi S. Thyroid disease and the heart. Circulation (2007) 116: 1725-1735
- Dagre AG, Lekakis JP, Papaioannou TG, Papamichael CM, Koutras DA, Stamatelopoulos SF, Alevizaki M. Arterial stiffness is increased in subjects with hypothyroidism. Int J Cardiol (2005) 103:1â€“6
- Obuobie K, Smith J, Evans LM, Sohn R, Davies JJ, Lazarus JH. Increased arterial central stiffness in hypothyroidism. J Clin Endocrinol Metab (2002) 87: 4662â€“4666
- Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation (2006) 113: 657â€“663
- Imaizumi M, Akahoshi M, Ichimaru S, Nakashima E, Hida A, Soda M. et al. Risk for ischemic heart disease and all cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab (2004) 89: 3365-3370
- Osman F, Gammage MD, Franklyn JA. Thyroid disease and its treatment: short-term and long-term cardiovascular consequences. Curr Op Pharmacol (2001) 1(6): 626-631
- Franco M, ChÃ¡vez E, PÃ©rez-MÃ©ndez O. Pleiotropic Effects of Thyroid Hormones: Learning from Hypo- thyroidism. J Thyroid Res (2011), ID 321030, 17 p
- Walsh JP, Bremner AP, Bulsara MK, Oâ€™Leary P, Leedman PJ, Feddema P, Michelangeli V. Subclinical thyroid dysfunction and blood pressure: a community-based study. Clin Endocrinol (2006) 65(4): 486â€“491
- Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical Thyroid Dysfunction: A Joint Statement on Management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society . J Clin Endocrinol Metabol (2005) 90 (1): 581-585
- Klein I, Kaie O. Thyroid hormone and blood pressure regulation. Laragh JH, Brenner BM (eds). Hypertension: Pathophysiology, Diagnosis and Management, 2nd edn. Raven Press Ltd: New York, 1995, p 2256
- Frohlich ED, Re RN. Pathophysiology of systemic arterial hypertension. In: Schlant RC, Alexander RW, Fuster V (eds). Hurstâ€™s The Heart, Arteries and Veins, 9th edn. McGraw-Hill, Inc: New York, 1998, p 1636
- Kaplan NM. Systemic hypertension, mechanism and diagnosis. In: Braunwald E (ed). Heart Disease: A Textbook of Cardiovascular Medicine, 5th edn. WB Saunders Company: Philadelphia, 1997, p 830
- Bergus GR, Randall C, Van Peusem R.The lack of association between hypertension and hypothyroidism in post-menopausal women patients seen in a primary care setting. J Am Board (1997) 10:185â€“191
- Dernellis J, Panaretou M. Effects of Thyroid Replacement Therapy on Arterial Blood Pressure in Patients with Hypertension and Hypothyroidism. Am Heart J (2002) 143(4): 718-724
- Iqbal A, Figenschau Y, Jorde R. Blood pressure in relation to serum thyrotropin: the TromsÃ¸ study. J Hum Hypertens (2006) 20: 932â€“936
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension (2003) 42: 1206â€“1252
- Klein I. Thyroid hormone and the cardiovascular system. Am J Med (1990) 88: 631â€“637
- Endo T et al. Re-evaluation of a possible high incidence of hypertension in hypothyroid patients. Am
- Heart J (1979) 98: 684â€“688
- Fletcher AK, Weetman AP. Hypertension and hypothyroidism. J Hum Hypertens (1998)12: 79â€“82
- Verdugo R, Wendel G, Trujillo L, Orellano G, Fuentes L. Characteristic of thyroid hormones in hypertensive hispanic population. J Life Scien (2012) 6(2): 155-163
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