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Hypothyroidism as a risk factor for cardiovascular disease
Bernadette Biondi1, Irwin Klein
1Department of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II School of Medicine, Via S. Pansini 5, 80131, Naples, Italy.
Endocrine
|July 14, 2004
Summary
Hypothyroidism, even mild cases, increases cardiovascular risks like atherosclerosis and functional abnormalities. Treatment with L-thyroxine effectively reverses these thyroid-related heart issues.
Area of Science:
- Endocrinology
- Cardiology
- Internal Medicine
Background:
- Hypothyroidism is linked to increased cardiovascular risk, encompassing functional abnormalities and atherosclerosis.
- Cardiovascular changes are observed in both subclinical and overt hypothyroidism, indicating thyroid hormone deficiency impacts the cardiovascular system.
- Impaired endothelial function, diastolic dysfunction, and reduced exercise capacity are common in hypothyroid patients.
Purpose of the Study:
- To investigate the cardiovascular risks associated with hypothyroidism, including functional abnormalities and atherosclerosis.
- To evaluate the reversibility of these cardiovascular abnormalities with L-thyroxine replacement therapy.
- To determine if the benefits of treating mild thyroid failure outweigh the risks.
Main Methods:
- Review of autopsy and epidemiological studies on thyroid hormone deficiency and cardiovascular risk.
- Assessment of cardiovascular parameters such as endothelial function, systolic and diastolic function, blood pressure, and systemic vascular resistance.
- Analysis of traditional and emerging risk factors for atherosclerosis in hypothyroid patients, including lipid profile, C-reactive protein, homocysteine, arterial stiffness, and coagulation parameters.
Main Results:
- Hypothyroid patients exhibit impaired endothelial function, diastolic dysfunction, and reduced physical capacity, which improve with L-thyroxine therapy.
- Atherosclerosis risk is elevated, associated with hypertension, atherogenic lipid profiles (especially with TSH >10 mU/L), and other factors like elevated C-reactive protein and homocysteine.
- Cardiovascular abnormalities are present even in mild thyroid failure (TSH levels <10 mU/L) and are reversible with treatment.
Conclusions:
- The cardiovascular system is significantly affected by hypothyroidism, manifesting as functional abnormalities and increased atherosclerosis risk.
- L-thyroxine replacement therapy effectively reverses these detrimental cardiovascular changes, even in cases of mild thyroid failure.
- The benefits of treating hypothyroidism with L-thyroxine outweigh the risks, highlighting the importance of timely intervention.