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Subclinical thyroid dysfunction as a risk factor for cardiovascular disease.

John P Walsh1, Alexandra P Bremner, Max K Bulsara

  • 1Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. john.walsh@health.wa.gov.au

Archives of Internal Medicine
|November 30, 2005
PubMed
Summary

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Subclinical hypothyroidism, a mild thyroid dysfunction, is linked to increased coronary heart disease risk. This study suggests it may be an independent risk factor for cardiovascular events.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Limited large-scale epidemiological studies exist on thyroid dysfunction and cardiovascular disease (CVD).
  • The role of subclinical hypothyroidism as a CVD risk factor remains unclear.

Purpose of the Study:

  • To investigate the association between subclinical thyroid dysfunction and coronary heart disease (CHD).
  • To determine if subclinical hypothyroidism is an independent risk factor for cardiovascular events.

Main Methods:

  • Analysis of 2108 serum samples from the 1981 Busselton Health Study in Western Australia.
  • Cross-sectional analysis of CHD prevalence in subjects with and without subclinical thyroid dysfunction.
  • Longitudinal analysis of cardiovascular mortality and CHD events up to 2001.

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Main Results:

  • Subclinical hypothyroidism was associated with a higher prevalence of CHD in cross-sectional analysis (OR, 1.8; P = .04).
  • Longitudinal analysis showed increased cardiovascular mortality (HR, 1.5; P = .08) and CHD events (HR, 1.7; P < .01) in subclinical hypothyroidism.
  • The elevated risk of CHD events persisted after adjusting for traditional cardiovascular risk factors.

Conclusions:

  • Subclinical hypothyroidism may serve as an independent risk factor for coronary heart disease.
  • Subclinical hyperthyroidism did not demonstrate adverse cardiovascular outcomes in this study.