Arterial stiffness in hyperthyroid patients is deteriorated due to thyroid hormones

Yıldız, Canan; Altay, Mustafa; Yıldız, Sedat; Çağır, Yavuz; Akkan, Tolga; Ünsal, Yasemin Aydoğan; Beyan, Eśin

doi:10.20945/2359-3997000000135

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…The normal range for PWV in adults aged 20-60 years is 5.86-8.15 m/s (45), whereas it is 400-600 mm for cIMT (17,45,46). These findings were different from other studies reporting that hyperthyroidism is related to an increase in PWV or cIMT (17,47,48). In addition, we did not find significant changes in PWV or cIMT after antithyroid treatment in our study.…”

Section: Discussioncontrasting

confidence: 99%

The Differential Effects of Propylthiouracil and Methimazole as Graves’ Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial

et al. 2021

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BackgroundHyperthyroidism is related to vascular atherosclerosis. Propylthiouracil (PTU) and methimazole, other than their antithyroid effects, may have different mechanisms in preventing atherogenesis in Graves’ disease.ObjectiveThis study aimed to investigate the effect of antithyroid drugs on markers of vascular atherosclerosis in Graves’ hyperthyroidism.MethodsThis study was a single-blind, randomized clinical trial conducted on 36 patients with Graves’ disease in Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from June 2019 until July 2020. Graves’ disease was diagnosed from clinical manifestation of hyperthyroidism with diffuse goiter and then confirmed by thyroid stimulation hormone (TSH), free T4 (fT4), and TSH-receptor antibody (TRAb) measurements. Participants were randomly assigned to either a PTU or a methimazole treatment group and followed up for 3 months. Markers of vascular atherosclerosis were represented by adhesion molecules [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin], carotid artery stiffness [pulse wave velocity (PWV)], and thickness [carotid intima media thickness (cIMT)].ResultsBy the end of the study, 24 participants reached euthyroid condition (13 from the PTU group and 11 from the methimazole group). After 3 months of follow-up, in the PTU group, we noticed an improvement of ICAM-1 [pretreatment: 204.1 (61.3) vs. posttreatment: 141.6 (58.4) ng/ml; p = 0.001], VCAM-1 [837 (707–977) vs. 510 (402–630) ng/ml; p < 0.001] and E-selectin [32.1 (24.1–42.7) vs. 28.2 (21.6–36.8) ng/ml; p = 0.045] in the PTU group. In the methimazole group, only VCAM-1 improvement [725 (565–904) vs. 472 (367–590); p = 0.001] was observed. Meanwhile, we found no significant changes in PWV or cIMT in either group.ConclusionAntithyroid treatment in Graves’ disease leads to improvement in adhesion molecules, with a lesser effect on methimazole, whereas there were no significant changes in PWV or cIMT. PTU may have a better mechanism compared with methimazole in terms of improving adhesion molecules.

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Section: Discussioncontrasting

confidence: 99%

The Differential Effects of Propylthiouracil and Methimazole as Graves’ Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial

et al. 2021

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“…Conversely, Bodlaj et al [ 55 ] found an increase in aortic AIx in hyperthyroidism patients with Graves’ disease. A negative correlation between AIx and TSH, and a positive correlation between AIx and free thyroid hormones (fT3, fT4) was also described by Yildiz et al [ 52 ]. Interpretation of these contrasting results probably resides in the close dependence of reflected waves timing with heart rate, which is acutely affected by thyroid hormones [ 56 ].…”

Section: Resultssupporting

confidence: 64%

“…Two studies evaluated the algorithm-derived PWV calculated from Mobil-O-Graph device in patients with hyperthyroidism, finding an increase in PWV in the office setting [ 52 ], which is not surprising considering that the PWV estimated by this method is strictly dependent on actual blood pressure values [ 53 ]. Interestingly, in another study the Mobil-O-Graph-derived PWV was not different in hyperthyroidism patients compared to blood-pressure matched controls [ 54 ], although the circadian profile of PWV was altered.…”

Section: Resultsmentioning

confidence: 99%

Arterial Stiffness in Thyroid and Parathyroid Disease: A Review of Clinical Studies

Grillo

Barbato

Antonello

et al. 2022

JCM

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Growing evidence shows that arterial stiffness measurement provides important prognostic information and improves clinical stratification of cardiovascular risk. Thyroid and parathyroid diseases are endocrine diseases with a relevant cardiovascular burden. The objective of this review was to consider the relationship between arterial stiffness and thyroid and parathyroid diseases in human clinical studies. We performed a systematic literature review of articles published in PubMed/MEDLINE from inception to December 2021, restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and thyroid and parathyroid diseases. For each selected article, data on arterial stiffness were extracted and factors that may have an impact on arterial stiffness were identified. We considered 24 papers concerning hypothyroidism, 9 hyperthyroidism and 16 primary hyperparathyroidism and hypoparathyroidism. Most studies evidenced an increase in arterial stiffness biomarkers in hypothyroidism, hyperthyroidism and primary hyperparathyroidism, even in subclinical and mild forms, although heterogeneity of measurement methods and of study designs prevented a definitive conclusion, suggesting that the assessment of arterial stiffness may be considered in the clinical evaluation of cardiovascular risk in these diseases.

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“…In another cohort which included 160 patients with hyperthyroidism-induced AF, the majority of ischaemic strokes occurred within the first 30 days of initial presentation of AF (73% vs. 80% in hyperthyroid AF vs. non-thyroid AF) [ 13 ]. Hyperthyroidism causes a proinflammatory, procoagulant state in acute phases [ 14 ], arterial remodelling, stiffness and atherosclerosis over longer terms [ 15 ]. The acute prothrombotic phase immediately following the diagnosis of hyperthyroidism might be a treatment window to prevent thromboembolism and other cardiovascular events [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Yearly Incidence of Stroke and Bleeding in Atrial Fibrillation with Concomitant Hyperthyroidism: A National Discharge Database Study

Zhang

Bisson

Fauchier

et al. 2022

JCM

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Background: Hyperthyroidism is associated with atrial fibrillation (AF), and the latter is a major risk factor for stroke. Aim: We aimed to investigate the yearly incidence of stroke and bleeding in AF patients with and without concomitant hyperthyroidism from the French National Hospital Discharge Database. Methods: Admissions with AF between January 2010 and December 2019 were retrospectively identified and retrieved from the French national database. Incidence rates of ischaemic stroke and bleeding were compared in AF patients with and without concomitant hyperthyroidism. The associations of risk factors with ischaemic stroke were assessed by Cox regression. Results: Overall 2,421,087 AF patients, among whom 32,400 had concomitant hyperthyroidism were included in the study. During the follow-up (mean: 2.0 years, standard deviation SD: 2.2 years), the yearly incidence of ischaemic stroke was noted to be 2.6 (95% confidence interval CI: 2.5–2.8) in AF patients with concomitant hyperthyroidism, and 2.3 (95%CI: 2.3–2.4) in non-thyroid AF patients. Hyperthyroidism was noted as an independent risk factor for ischaemic stroke (adjusted hazard ratio aHR: 1.133, 95%CI: 1.080–1.189) overall, particularly within the first year of hyperthyroidism diagnosis (aHR 1.203, 95%CI 1.120–1.291), however, the association became non-significant in subsequent years (aHR 1.047, 95%CI 0.980–1.118). Major bleeding incidence was lower in the hyperthyroid AF group in comparison to the non-thyroid AF group (incidence ratio: 5.1 vs. 5.4%/year, p < 0.001). The predictive value of CHA2DS2VASc and HAS-BLED scores for ischaemic stroke and bleeding events, respectively, did not differ significantly between AF patients with or without concomitant hyperthyroidism. Conclusions: Hyperthyroidism seems to be an independent risk factor of ischaemic stroke in AF patients, particularly within the first year of hyperthyroidism diagnosis.

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Arterial stiffness in hyperthyroid patients is deteriorated due to thyroid hormones

Cited by 10 publications

References 16 publications

The Differential Effects of Propylthiouracil and Methimazole as Graves’ Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial

The Differential Effects of Propylthiouracil and Methimazole as Graves’ Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial

Arterial Stiffness in Thyroid and Parathyroid Disease: A Review of Clinical Studies

Yearly Incidence of Stroke and Bleeding in Atrial Fibrillation with Concomitant Hyperthyroidism: A National Discharge Database Study

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