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Thyroid hormone use, hyperthyroidism and mortality in older women
Douglas C Bauer1, Nicolas Rodondi, Katie L Stone
1Division of General Internal Medicine, University of California, San Francisco, CA 94107, USA. dbauer@psg.ucsf.edu
The American Journal of Medicine
|April 3, 2007
Summary
Thyroid hormone use in older women showed no significant link to increased mortality. However, a history of hyperthyroidism was associated with a slight rise in all-cause and cardiovascular death risk.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Epidemiology
Background:
- Thyroid dysfunction is prevalent in elderly women.
- The long-term safety of thyroid hormone replacement and prognosis of hyperthyroidism require further investigation.
Purpose of the Study:
- To investigate the association between thyroid hormone use, prior hyperthyroidism, thyroid function, and mortality in older women.
- To clarify the risks associated with thyroid dysfunction management in this demographic.
Main Methods:
- Prospective cohort study of 9449 women aged 65+ over 12 years.
- Nested case-cohort analysis (n=487) using third-generation thyroid-stimulating hormone assay.
- Adjudicated causes of death based on death certificates and hospital records.
Main Results:
- Thyroid hormone users (12%) did not exhibit significantly higher mortality compared to non-users (RH 1.11, P=.09).
- Previous hyperthyroidism was linked to increased all-cause (RH 1.20) and cardiovascular mortality (RH 1.46).
- Abnormal thyroid-stimulating hormone levels (<0.5 or >5 mU/L) showed no significant mortality association, though statistical power was limited.
Conclusions:
- Thyroid hormone therapy appears safe regarding mortality in older women.
- A history of hyperthyroidism may confer a modest increase in mortality risk.
- Further research on hyperthyroidism and its treatment is warranted.
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