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Cardiovascular risk factors in middle-aged women with subclinical hypothyroidism
Rafael Luboshitzky1, Paula Herer
1Endocrine Institute, Haemek Medical center, Afula, Israel. Luboshitzky_r@clalit.org.il
Insights
Subclinical hypothyroidism in middle-aged women is linked to hypertension and dyslipidemia, but not elevated C-reactive protein or homocysteine levels. These factors do not appear to increase coronary heart disease risk in this group.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Overt hypothyroidism (OH) is a known risk factor for premature atherosclerosis and coronary heart disease (CHD).
- Subclinical hypothyroidism (SH), prevalent in 15% of middle-aged women, has an unclear association with CHD risk.
- C-reactive protein (CRP) and total homocysteine (tHct) are emerging cardiovascular risk factors.
Purpose of the Study:
- To investigate cardiovascular risk markers in middle-aged women with newly diagnosed subclinical hypothyroidism (SH).
- To compare CRP and tHct levels in SH patients against overt hypothyroidism (OH) and euthyroid controls.
- To assess the association of SH with hypertension, dyslipidemia, and other cardiovascular risk factors.
Main Methods:
- Measurement of CRP and tHct levels in 44 middle-aged women with newly diagnosed SH.
- Comparison of cardiovascular risk markers, including blood pressure and lipid profiles, with 10 OH patients and 19 euthyroid controls.
- Analysis of correlations between CRP, tHct, and other parameters like BMI and age.
Main Results:
- Subclinical hypothyroidism (SH) patients did not show significantly augmented CRP or tHct levels compared to controls.
- Mean systolic and diastolic blood pressure were significantly increased in SH patients versus controls.
- While mean lipid profiles were similar, a higher percentage of SH patients exhibited hypertension, hypertriglyceridemia, hypercholesterolemia, and unfavorable cholesterol ratios.
Conclusions:
- Subclinical hypothyroidism in middle-aged women is associated with hypertension and dyslipidemia.
- CRP and tHct do not appear to be major contributors to CHD risk in women with SH.
- Further research is needed to fully elucidate the cardiovascular implications of SH.
Objectives:
Overt hypothyroidism (OH) is associated with premature atherosclerosis and coronary heart disease (CHD). Recently, C-reactive protein (CRP) and total homocysteine (tHct) emerged as additional independent cardiovascular risk factors. Subclinical hypothyroidism (SH), affecting as many as 15% of middle-aged women is not known to be associated with risk for CHD.
Design And Measurements:
We measured CRP and tHct levels as well as conventional cardiovascular risk markers in 44 middle-aged women with newly diagnose SH. Results were compared with those obtained in 10 patients with OH and 19 euthyroid controls.
Results:
In SH, tHct and CRP levels were not as augmented as compared to controls. Their mean systolic and diastolic blood pressure values were increased vs. controls (p<0.04;p<0.01, respectively). Mean values of total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides, TC/HDL-C and LDL-C/HDL-C were not different in patients with SH compared to controls. Individual analysis revealed that the percentage of patients with SH having hypertension, hypertriglyceridemia, hypercholesterolemia, elevated TC/HDL-C and LDL-C/HDL-C ratios were higher than the percentage in controls. CRP positively correlated with BMI(r=0.29,p<0.02), and tHct positively correlated with age (r=0.24, p<0.05).
Conclusions:
Our findings suggest that subclinical hypothyroidism in middle-aged women is associated with hypertension and dyslipidemia. CRP and tHct do not appear to contribute to the increased risk for CHD in these patients.
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