Cor Vasa 2004, 45(3):123-127
Is subclinical hypothyroidism a risk factor for cardiovascular disease?
- II. interní klinika, Centrum preventivní kardiologie, Fakultní nemocnice a Lékařská fakulta Univerzity Karlovy, Plzeň, Česká republika
Subclinical hypothyroidism (SH) is defined as elevated serum thyroid-stimulating hormone (TSH) levels, but still in the presence of normal free thyroxine levels. A recent retrospective case-control study reported SH was associated with a doubling in the relative risk of myocardial infarction. Similar to overt hypothyroidism, SH has been reported to be associated with several cardiovascular risk factors. Beside the well-established ones such as total and LDL-cholesterol, it was associated with some of the new risk factors such as homocysteine, C-reactive protein, lipoprotein Lp(a), or endothelial dysfunction. Hemodynamic parameters such as cardiac output and peripheral vascular resistance could also be influenced.
SH is the most common thyreopathy, with an overall prevalence reported to be from 4 to 10% in large population surveys, and with a marked increase in elderly subjects and in females. In patients with clinical coronary heart disease (Czech sample of EUROASPIRE II), we found hypothyroidism (overt or subclinical) to be present in 6.9% of males and 23.4% of females. An even higher prevalence was noted in subgroups of males with hypertension, females with hypercholesterolemia, overt diabetes and hyperhomocysteinemia, as well as in males and females with positive thyroid antibodies (aTPO).
Keywords: Subclinical hypothyroidism; Coronary heart disease; Risk factors; Treatment
Published: March 1, 2004 Show citation