[Subclinical hypothyroidism and arteriosclerosis]

Overt hypothyroidism predisposes to the development of atherosclerosis. Recent data indicate that subclinical hypothyroidism is also associated with enhanced risk for arteriosclerotic cardiovascular disease, which could be attributed to multiple mechanisms such as hyperlipidemia, hypercoagulable state, direct effects on vascular smooth muscle or endothelial dysfunction. The relationship between subclinical hypothyroidism and atherosclerosis is, however, still ambiguous. The elucidation of this problem is important as subclinical hypothyroidism is a relatively common condition, and if necessary early T4 substitution therapy given to adequately selected patients could prevent the development of atherosclerosis. In the reflection of recent literature this article deals with the probable mechanisms responsible for the presumed accelerated arteriosclerosis in subclinical hypothyroidism.