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Hyperthyroidism and cardiovascular risk factors: A nationwide study
1Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda (Majadahonda), Madrid, Spain; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Spain; Department of Medicine, Universidad Autónoma de Madrid, Spain.
Insights
Hyperthyroidism is linked to major cardiovascular risk factors like hypertension and dyslipidemia in Spain. However, this association with diabetes diminishes in older adults aged 65 and above.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Public Health
Background:
- Thyroid hormones (THs) critically influence cardiovascular (CV) physiology.
- Thyroid disorders are strongly associated with significant CV system complications.
Purpose of the Study:
- To investigate the association between hyperthyroidism and key cardiovascular risk factors (CVRFs) including hypertension, dyslipidemia, diabetes, and smoking.
- Focus on the Spanish population within a primary care setting.
Main Methods:
- Observational, retrospective, non-interventional study design.
- Utilized data from the Spanish Ministry of Health's statistical portal and the Base de Datos Clínicos de Atención Primaria (BDCA) database.
- Analyzed a large cohort of 38,365,258 individuals registered in the BDCA database.
Main Results:
- In 2019, hyperthyroidism affected 1.0% of the registered population (384,182 individuals), being more prevalent in women and increasing with age.
- Individuals with hyperthyroidism showed significantly higher prevalence of hypertension (OR 2.16), dyslipidemia (OR 1.90), diabetes (OR 1.66), and smoking (OR 1.48) compared to those without.
- In individuals aged 65+, significant associations persisted for hypertension, dyslipidemia, and smoking, but not for diabetes.
Conclusions:
- Hyperthyroidism is significantly associated with major cardiovascular risk factors in the Spanish primary care population, irrespective of gender.
- The association between hyperthyroidism and diabetes as a cardiovascular risk factor is not observed in patients aged 65 and older.
Background:
Thyroid hormones (THs) have important effects on cardiovascular (CV) physiology. Thyroid disorders are accompanied by serious effects on the CV system.
Objective:
To study the association between hyperthyroidism and the main CV risk factors (CVRFs), such as hypertension, dyslipidemia, diabetes and smoking in the Spanish population.
Material And Methods:
An observational, retrospective, non-interventional study was performed using the statistical portal of the Spanish Ministry of Health associated with the Base de Datos Clínicos de Atención Primaria (BDCA) database.
Results:
In 2019, 384,182 people [300,243 women (78.1%)] were diagnosed with hyperthyroidism, which represents 1.0% of the population with health problems registered in the BDCAP database (38,365,258 people). The prevalence of hyperthyroidism was more frequent in women (2.48 times) than in men and increased with age. When the whole population was considered, the prevalence of hypertension (34.90% vs. 19.90%; odds ratio, OR 2.16, 95% CI 2.14-2.17), dyslipidemia (34.47% vs. 21.57%; OR 1.90, 95% CI 1.88-1.91), diabetes (12.88% vs. 8.12%; OR 1.66, 95% CI 1.65-1.68) and smoking (10.89% vs. 7.61%; OR 1.48, 95% CI 1.46-1.49) was significantly (p<0.0001) higher in the population diagnosed with hyperthyroidism compared to those without this diagnosis. These significant differences were maintained in both women and men. A separate analysis of the age group 65 years or older showed statistically significant (p<0.0001) differences in the prevalence of hypertension (66.26% vs. 59.43%; OR 1.34, 95% CI 1.33-1.36), dyslipidemia (52.61% vs. 49.05%; OR 1.15, 95% CI 1.14-1.17) and smoking (6.29% vs. 5.93%; OR 1.06, 95% CI 1.04-1.09) between patients with and without a diagnosis of hyperthyroidism, but not in the prevalence of diabetes, which was similar (24.63% vs. 24.63%; OR 1.00, 95% CI 0.99-1.01; p=0.89).
Conclusion:
Our study shows that the diagnosis of hyperthyroidism is significantly associated with the main CVRFs in Spanish population attended by primary care regardless of the gender of the patients. This association disappears in those patients aged 65 years or older diagnosed with diabetes.
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