Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Cai, Yunfei; Ren, Ying; Shi, Jingpu

doi:10.1038/hr.2011.91

Cited by 75 publications

(58 citation statements)

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“…2 Subclinical hyperthyroidism reportedly increases heart rate, the frequency of arrhythmia (including atrial fibrillation), left ventricular mass and the risk of cardiovascular mortality; it also impairs ventricular relaxation. 3 However, the relationship between subclinical thyroid dysfunction and hypertension has remained controversial.In this issue, Cai et al 4 report the result of a meta-analysis, in which they aimed to determine whether subclinical thyroid dysfunction affects blood pressure. Their findings indicate that subclinical hypothyroidism is associated with a significant risk of increased blood pressure, both systolic and diastolic blood pressure, whereas subclinical hyperthyroidism is not associated with increased blood pressure.…”

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confidence: 99%

“…Their findings indicate that subclinical hypothyroidism is associated with a significant risk of increased blood pressure, both systolic and diastolic blood pressure, whereas subclinical hyperthyroidism is not associated with increased blood pressure. 4 They suggest that the controversy regarding the relationship between subclinical hypothyroidism and hypertension may derive from the small number of subjects in the case-control studies, selection bias, or differences in race, lifestyle and genetic background among the sampled population. 4 We need to consider several aspects of thyroidology and laboratory medicine as factors that affected the analysis of the results.…”

mentioning

confidence: 99%

“…4 They suggest that the controversy regarding the relationship between subclinical hypothyroidism and hypertension may derive from the small number of subjects in the case-control studies, selection bias, or differences in race, lifestyle and genetic background among the sampled population. 4 We need to consider several aspects of thyroidology and laboratory medicine as factors that affected the analysis of the results. These aspects can be divided into the following four concepts.…”

mentioning

confidence: 99%

“…In this issue, Cai et al 4 report the result of a meta-analysis, in which they aimed to determine whether subclinical thyroid dysfunction affects blood pressure. Their findings indicate that subclinical hypothyroidism is associated with a significant risk of increased blood pressure, both systolic and diastolic blood pressure, whereas subclinical hyperthyroidism is not associated with increased blood pressure.…”

mentioning

confidence: 99%

“…8 At present, the laboratory tests for TSH, FT4 and FT3 designed to analyze thyroid function vary among institutions around the world because commercial kits used for clinical laboratory tests have not yet been internationally standardized. 8 Several types of commercial kits were used to measure thyroid function in the study by Cai et al 4 The standardization of clinical laboratory tests is very important because it facilitates clinical interpretation and allows for comparison of assay results across different studies and clinical laboratories. 9 However, many biological and methodological challenges complicate the standardization of immunoassays for thyroid function.…”

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Does subclinical thyroid dysfunction affect blood pressure?

Nakata

2011

Hypertens Res

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A highly sensitive immunoassay for thyroid-stimulating hormone (TSH) was developed in the 1980's for the diagnosis of patients with subclinical thyroid dysfunctions. The frequency of subclinical hypothyroidism is 4.3-11.8% and that of subclinical hyperthyroidism is 0.7-1.5%. 1 An association between subclinical hypothyroidism and cardiovascular risks and the development of atherosclerosis has been reported. 2 Subclinical hyperthyroidism reportedly increases heart rate, the frequency of arrhythmia (including atrial fibrillation), left ventricular mass and the risk of cardiovascular mortality; it also impairs ventricular relaxation. 3 However, the relationship between subclinical thyroid dysfunction and hypertension has remained controversial.In this issue, Cai et al. 4 report the result of a meta-analysis, in which they aimed to determine whether subclinical thyroid dysfunction affects blood pressure. Their findings indicate that subclinical hypothyroidism is associated with a significant risk of increased blood pressure, both systolic and diastolic blood pressure, whereas subclinical hyperthyroidism is not associated with increased blood pressure. 4 They suggest that the controversy regarding the relationship between subclinical hypothyroidism and hypertension may derive from the small number of subjects in the case-control studies, selection bias, or differences in race, lifestyle and genetic background among the sampled population. 4 We need to consider several aspects of thyroidology and laboratory medicine as factors that affected the analysis of the results. These aspects can be divided into the following four concepts.

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Does subclinical thyroid dysfunction affect blood pressure?

Nakata

2011

Hypertens Res

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Association between subclinical hypothyroidism and metabolic disorders: A retrospective chart review study in an emerging university hospital

Aldossari

Al-Ghamdi

Al-Zahrani

et al. 2019

Clinical Laboratory Analysis

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BackgroundSubclinical hypothyroidism is defined as an increase in serum levels of Thyroid Stimulating Hormone (TSH) above the normal range, without alteration of total T4 concentrations that is reported to have association with various metabolic conditions. The study aimed to investigate any association between subclinical hypothyroidism and metabolic disorders in Al Kharj city.MethodsThis is a cross‐sectional study that included review of patients’ charts from prince Sattam bin Abdul‐Aziz University, Al Kharj, Saudi Arabia, from August 1 to November 30, 2016. Data were analyzed with SPSS version 21. Descriptive statistics were obtained as frequencies. Pearson chi‐square analysis was used to assess any differences between disease status and study variables. P‐value < 0.05 was considered significant.ResultsThe mean age was 30.65 ± 13.3 with a female predominance. The average BMI was 29.5 ± 7.71; 46 (11.5%) had hypertension, 52 (46.8%) had diabetes, 173 (44%) had anemia, and 192 (56%) had vitamin D deficiency. Due to increased TSH levels, male gender had higher prevalence of subclinical hypothyroidism with P‐value < 0.001 and 0.011, respectively.ConclusionSubclinical hypothyroidism is a significant topic worldwide whose prevalence is rising. In this study, we could not find any significant association between subclinical hypothyroidism and metabolic disorder. Further longitudinal studies with large sample size are needed to study this association.

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Endocrine Hypertension and Chronic Kidney Disease

Koch

Pamporaki

Kantorovich

2014

Chronic Kidney Disease and Hypertension

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IntroductionEndocrine forms of secondary hypertension (HTN) have traditionally included syndromes of mineralocorticoid excess with primary aldosteronism (PA) representing the most common etiology, followed by Cushing's syndrome (CS), and pheochromocytoma. Besides these conditions of hormonal excess, there are also other rare conditions such as congenital adrenal hyperplasia (11β-hydroxylase, 17α-hydroxylase deficiency), apparent mineralocorticoid excess, Geller syndrome (mineralocorticoid receptor (MR) activation), Liddle syndrome, pseudohypoaldosteronism type 2, and Chrousos syndrome that can cause HTN [1-4] (see Fig. 16.1).When considering the current obesity epidemic, with its many hormonal derangements (e.g., deficiencies of testosterone, vitamin D, growth hormone), the hitherto estimated prevalence rates of approximately 10 % for endocrine HTN are likely to be an underestimate. Potential nonadrenal causes of endocrine HTN include excess production of growth hormone (acromegaly), thyroid hormone, and parathyroid hormone, as well as insulin resistance, hypothyroidism, and overstimulation of central MRs [1,. These "nontraditional" forms of endocrine HTN will not be discussed in detail in this chapter.Cutoffs of systolic and diastolic blood pressure (BP) for defining HTN along with reference ranges for hormonal assays among various patient populations are 186 C. A. Koch et al. all important to consider when applying existing or emerging data to clinical patient scenarios. HTN guidelines by various societies have been recently revisited [41][42][43][44][45][46]. The American Society of Hypertension/International Society of Hypertension (ASH/ISH) guidelines reaffirm the traditional threshold of 140/90 mmHg as a cutoff for defining an elevated BP and state that individuals with a BP of 140-159/90-99 mmHg and no other risk factors are considered at low risk. On the other hand, the Joint National Committee (JNC 8) suggests a systolic blood pressure (SBP) of 150 mmHg as a worrisome threshold, especially for those 80 years and older. For the diastolic BP goal, both the ASH/ISH and JNC 8 guidelines view 90 mmHg as the cutoff; the exception are diabetic hypertensives for whom the cutoff is 85 mmHg. From epidemiologic studies and drug trials, there appears no sound evidence to continue recommending a BP of 140/90 mmHg as the cutoff to initiate antihypertensive treatment; moreover, any increased benefit from additional antihypertensive medications can be nonexistent or negligible, particularly in the face of increased likelihood of adverse effects. .1 Inherited endocrine condition related to mineralocorticoid excess. The picture shows the molecular pathways involved in dysregulation of NaCl homeostasis located in the distalrenal tubules. AME apparent mineralocorticoid excess; GRA glucocorticoid-remediable aldosteronism; PHA2 pseudohypoaldosteronism type 2; MR mineralocorticoid receptor; WNK with-no-lysine ( K) kinase 1,4; ROMK renal outer medullary potassium channel; ENaC epithelial sodium channel; KLHL3 kelch-like 3; C...

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Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Cited by 75 publications

References 29 publications

Does subclinical thyroid dysfunction affect blood pressure?

Does subclinical thyroid dysfunction affect blood pressure?

Association between subclinical hypothyroidism and metabolic disorders: A retrospective chart review study in an emerging university hospital

Endocrine Hypertension and Chronic Kidney Disease

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