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Subclinical hyperthyroidism and the risk of developing cardiovascular disease - a systematic review

Stine Bech Smedegaard1, Anne Lene Riis, Morten Krogh Christiansen

  • 1Stinsmed@rm.dk.

Danish Medical Journal
|November 20, 2020
PubMed

Insights

Subclinical hyperthyroidism (SH) is linked to increased risks of atrial fibrillation (AF) and heart failure (HF). However, current research does not support a connection between SH and myocardial infarction (MI) or cardiovascular mortality.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • The cardiovascular risks associated with subclinical hyperthyroidism (SH) remain a subject of ongoing debate.
  • SH is a condition characterized by suppressed thyroid-stimulating hormone levels with normal circulating thyroid hormone concentrations.

Purpose of the Study:

  • To systematically review the existing literature on the association between subclinical hyperthyroidism and major cardiovascular outcomes.
  • To evaluate the evidence linking SH to atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), and cardiovascular mortality.

Main Methods:

  • A comprehensive literature search was conducted using the PubMed database.
  • Included studies were observational, focused on SH in human subjects, and reported on outcomes such as AF, HF, MI, or cardiovascular mortality.
  • Studies published in English or Danish with euthyroid controls were selected.

Main Results:

  • A total of 33 observational studies were included in the review.
  • Evidence from 13 studies supported an association between SH and an increased risk of AF.
  • Evidence from five studies supported an association between SH and an increased risk of HF.

Conclusions:

  • The current body of evidence suggests a significant association between subclinical hyperthyroidism and increased risks of atrial fibrillation and heart failure.
  • The reviewed literature did not establish a clear association between subclinical hyperthyroidism and the risk of myocardial infarction or overall cardiovascular mortality.
Abstract

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