[Pathogenesis of arterial hypertension in patients with primary hypothyroidism]

The aim of this work was to study the role of hypovolemia on pathogenesis of arterial hypertension (AH) in patients with primary hypothyroidism (PH) and specification of indirect signs indicative of increased circulating blood volume. 217patients with PH and AH (mean age 53.3 yr) received substitution therapy with sodium levothyroxin and standard hypotensive therapy with ACE inhibitors. All the patients allocated to 3 groups were examined by 24 hour Holter monitoring and measurement of serum TSH and free T4. Group 1 (n = 74) were patients with compensated PH, group 2 (n = 57) comprised patients with subclinical hypothyroidism, group 3 (n = 86) were patients with decompensated hypothyroidism. The latter group was dominated by non-dippers, the patients showed elevated systolic and diastolic AD, its small reduction and high variability at night time. These clinical and functional signs are supposed to reflect hypovolemia in patients with PH and concomitant AH.