Hypothyroidism and metabolic cardiovascular disease
Armando Patrizio1, Silvia Martina Ferrari2, Giusy Elia3
1Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Insights
Thyroid disorders like hypothyroidism can impact cardiovascular disease (CVD) risk. Treatment for subclinical hypothyroidism with levothyroxine shows benefits, especially in younger adults, but remains debated for older individuals.
Area of Science:
- Endocrinology and Cardiovascular Medicine
- Thyroid hormone's role in cardiovascular physiology
- Epidemiology of thyroid dysfunction and cardiovascular disease
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality.
- Thyroid dysfunction, including hyperthyroidism and hypothyroidism, is prevalent in adults.
- Both thyroid disorders can influence the development and progression of CVD.
Purpose of the Study:
- To review the role of thyroid hormones in cardiovascular health.
- To analyze the clinical impact of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) on cardiovascular risk and mortality.
- To summarize evidence regarding levothyroxine (L-T4) treatment for SCH.
Main Methods:
- Review of physiological mechanisms linking thyroid hormones to cardiovascular function.
- Analysis of updated clinical data on overt and subclinical hypothyroidism.
- Summary of current evidence and guidelines on treating subclinical hypothyroidism.
Main Results:
- Thyroid hormone alterations can affect cardiac function, blood pressure, endothelial function, and lipid profiles.
- Current guidelines suggest treating SCH with TSH > 10 mIU/L, with clearer benefits in younger populations.
- Levothyroxine therapy for SCH in individuals over 65 remains controversial.
Conclusions:
- Thyroid dysfunction significantly impacts cardiovascular health and mortality.
- Levothyroxine treatment for SCH has demonstrated benefits, particularly in younger individuals.
- Further research is essential to guide the clinical management of cardiovascular risk in elderly patients with SCH.
Abstract:
Cardiovascular disease (CVD) remains the leading cause of death worldwide, representing a major health issue of social and economic relevance. Both hyperthyroidism and hypothyroidism are very common in the adult population, and both disorders may contribute to the onset and progression of CVD. After a brief description of the role of thyroid hormones (THs) on the physiology of the cardiovascular system and the potential mechanism that links THs alterations with changes in cardiac function, blood pressure, endothelial function, and lipid levels, we review updated data about the clinical impact of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) on CV risk, CVD, and mortality. Furthermore, we summarize the current evidence for treating SCH with levothyroxine (L-T4). Several guidelines of distinguished endocrine societies recommend treatment for SCH with TSH higher than 10 mIU/L, where the benefit of L-T4 therapy is more evident for younger people, but still controversial in those aged over 65 years. Based on current knowledge, more research efforts are needed to better address the clinical management of CV risk and CVD in the elderly affected by SCH.
Related Concept Videos
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:19Overview of Carbohydrate Metabolism
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:29Cholesterol: Significance and Regulation
Considering cholesterol and...