Hypothyroidism in coronary heart disease and its relation to selected risk factors

Mayer, Otto; Šimon, J; Filipovský, Jan; Plášková, M.; Pikner, Richard

doi:10.2147/vhrm.2006.2.4.499

Cited by 43 publications

(36 citation statements)

References 32 publications

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“…Other similar studies also reported same findings. 9,12 In present study 78.8% of hypothyroid patients had elevated BMI which was also comparable to Knudsen et al 18,19 In the study sample 71.4% hypothyroid patients had elevated total cholesterol and 39.6% euthyroid patients had elevated total cholesterol. 71.4% hypothyroid patients had elevated triglycerides and 41.9% euthyroid patients had elevated triglycerides.…”

Section: Discussionsupporting

confidence: 89%

“…11 This causes accelerated atherosclerosis and increased incidence of coronary artery heart disease. 9,[12][13][14][15] Elevated homocysteine levels and low grade inflammation, as suggested by elevated CRP are the other risk factors for coronary artery disease in hypothyroidism. 16,17 This study was conducted to find out the prevalence of hypothyroidism in patients with coronary artery diseaseacute myocardial infarction and to find out the relation of hypothyroidism to factors like hypercholesterolemia and diastolic hypertension in the study population.…”

Section: Introductionmentioning

confidence: 99%

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Study on prevalence of hypothyroidism in ST segment elevation myocardial infarction

Sreevidya

Renymol

2017

Int J Res Med Sci

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Background: Both subclinical and overt hypothyroidism have effects on myocardial contractility and cardiovascular haemodynamics. In addition, changes in lipids, low levels of inflammation, elevated homocysteine etc. contribute to accelerated atherosclerosis and increased cardio vascular mortality and morbidity in hypothyroidism. In this study, we tried to find out the prevalence of hypothyroidism in patients admitted with acute ST elevation myocardial infarction. We also tried to assess the BMI, diastolic BP and lipid profile of these patients.Methods: A cross sectional study was done among patients admitted with ST elevation myocardial infarction in Coimbatore Medical College, Coimbatore, Tamil Nadu, India. We collected information on BMI, blood pressure, lipid profile and thyroid function of these patients.Results: The prevalence of hypothyroidism was found to be 14% in patients admitted with ST elevation MI. Hypothyroidism was three times more common in women. Patients with hypothyroidism was found to have higher BMI, elevated total cholesterol, triglycerides and LDL which was statistically significant. Higher prevalence of diastolic hypertension was also seen among hypothyroid patients.Conclusions: Thyroid hormone has various actions on heart. Hypothyroidism has increased cardiovascular morbidity and mortality. The associated risk factors like obesity, hyperlipidaemia and diastolic hypertension contribute to this. Patients with coronary artery disease should be screened for hypothyroidism.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Study on prevalence of hypothyroidism in ST segment elevation myocardial infarction

Sreevidya

Renymol

2017

Int J Res Med Sci

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“…Other studies have not shown significant difference in systolic and diastolic blood pressure between males and females. 9,10 Significantly, more number of females had abnormal heart sound as compared to males (p < 0.0001) in our study. We did not find other studies comparing heart sounds between male and female patients of hypothyroidism.…”

Section: Discussionsupporting

confidence: 47%

Cardiovascular Manifestations in Patients of Hypothyroidism- Results of a Single Centre Study

Deshpande¹,

Sharma²,

Walke³

et al. 2017

jemds

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BACKGROUNDObjective-To examine cardiovascular manifestations in patients with hypothyroidism. MATERIALS AND METHODSIn this observational study, adult hypothyroid patients were screened for cardiovascular disease. Symptoms of hypothyroidism, cardiovascular system related symptoms, T3, T4 and Thyroid Stimulating Hormone (TSH) were compared between male and female patients. Association between thyroid stimulating hormone and heart disease was also evaluated. RESULTSHundred patients (male 32% and female 68%) with mean age of 39.2 + 9.28 years were enrolled. More number of females showed weight gain over a period of two years as compared to males (p= 0.0217). Dry skin was more common in females as compared to males (p= 0.0336). More females reported breathlessness and chest pain as compared to males (breathlessness p= 0.0187; chest pain p= 0.0008). Pulse rate of female patients was significantly lower than male patients (p= 0.0081). More number of females had raised jugular venous pressure as compared to males (41% vs 19%, p= 0.0475). Diastolic blood pressure was higher in females than in males (p= 0.023). There was no difference in the mean T3 (52.43 ± 14.35 pg/mL vs 46.53 ± 14.19 pg/mL; p= 0.1776), T4 level (4.48 ± 0.97 vs 4.06 ± 0.97; p= 0.1630) or TSH level (31.19 ± 11.9 vs 42.21 ± 26.98; p= 0.1260) between males and females. Number of females with cardiomegaly was higher compared to males [26 (38%) vs 2 (6%); p < 0.0001]. Significant association was observed between higher TSH and presence of breathlessness, chest discomfort and palpitations (p < 0.05). Significantly, more patients with higher TSH showed significantly more heart rate, raised jugular venous pressure and diastolic blood pressure (p < 0.05). Higher TSH was associated with pericardial effusion in more proportion of patients (p= 0.007). CONCLUSIONCardiac dysfunction is common in patients with hypothyroidism. Screening and treatment of cardiovascular disease in hypothyroidism may help to reduce morbidity and mortality in hypothyroidism. KEYWORDS BACKGROUNDHypothyroidism is a common endocrinological problem in clinical practice. The reported incidences of clinical hypothyroidism range from 0.5 to 1.9% in women and less than 1% in men. Subclinical hypothyroidism is more common than clinical hypothyroidism, both in females and males. 1 The prevalence of subclinical hypothyroidism is about 4 -10.5%. 2 Both clinical and subclinical hypothyroidism are shown to be associated with cardiovascular manifestations. As heart is

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“…19) The fi nding of a reduced ejection fraction in our patients with subclinical dysthyroidism suggests systolic dysfunction even in mild thyroid pathology. 20,21) HRV has been proved to be a useful tool in the study of the integrated cardiovascular control system mechanisms and to be associated with the cardiovascular risk in many pathological conditions, mostly myocardial infarction, congestive heart failure, and diabetic autonomic neuropathy. 7) In the literature, only a few studies assessed heart rate variability in patients with thyroid dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Time-Domain Heart Rate Variability in Coronary Artery Disease Patients Affected by Thyroid Dysfunction

et al. 2014

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SummarySubclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with negative effects on the cardiovascular system. Moreover, the effect of treated thyroid dysfunction on parameters associated with the cardiovascular control system has been poorly investigated. In the present study we analyzed time-domain heart rate variability in coronary artery disease (CAD) patients with known thyroid diseases. Twenty-four hour ECG monitoring was performed in 344 patients with coronary artery disease (174 with thyroid dysfunction and 170 without thyroid dysfunction used as a control group), using a 3-channel tape recorder. Time domain parameters of heart rate variability (HRV) were defi nitely lower both in patients with subclinical hypothyroidism and subclinical hyperthyroidism than in the control group, with statistically signifi cant differences in SDNN, RMSSD, TINN, and mean RR for both subgroups. Furthermore, patients on L-thyroxine treatment and restored euthyroidism had generally higher HRV values than patients with subclinical hypothyroidism, nevertheless SDNN, RMSSD, SDNN index, TINN, and mean RR were signifi cantly lower when compared to those of the control group. Signifi cant differences in HRV were also found between hyperthyroid patients under treatment and control group subjects with respect to RMSSD, TINN, and mean RR values. In conclusion, patients with cardiac disease and known thyroid disease, even when the disease is in the subclinical range or despite treatment, should be regarded as patients at additional risk conveyed by thyroid hormone disturbances. (Int Heart J 2014; 55: 33-38) Key words: Hyperthyroidism, Hypothyroidism, Autonomic, Regulation, Cardiovascular risk T hyroid hormones perform a fundamental role in maintaining cardiovascular homeostasis, since they act both directly on the heart muscle and by modulating the autonomic nervous system. Typical clinical signs of hyperthyroidism such as increases in heart rate, cardiac output, systolic blood pressure, myocardial contractility, and basal metabolism and the presence of tremor suggest a hyperadrenergic state. This is possibly due to a greater sensitivity to catecholamines, since their plasmatic concentration in hyperthyroid patients is normal.1) It has been hypothesized that hyperthyroid patients could have alterations either in the number or in the affinity of adrenergic receptors.2) Hypothyroidism instead seems to evoke a hypoadrenergic state due to the presence of bradycardia, reduced cardiac output, and reduced basal metabolism. Intracellular catecholamine production from circulating lymphocytes has been found to be lower during short-term hypothyroidism in patients who have undergone thyroidectomy for differentiated thyroid carcinomas, as compared to the values found during hormone replacement therapy.3) Nevertheless, in contrast with the reduced adrenergic reactions at the cardiac, metabolic, and cellular levels, the plasmatic concentration of norepinephrine is increased in those patients.4) Through the ev...

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Hypothyroidism in coronary heart disease and its relation to selected risk factors

Cited by 43 publications

References 32 publications

Study on prevalence of hypothyroidism in ST segment elevation myocardial infarction

Study on prevalence of hypothyroidism in ST segment elevation myocardial infarction

Cardiovascular Manifestations in Patients of Hypothyroidism- Results of a Single Centre Study

Time-Domain Heart Rate Variability in Coronary Artery Disease Patients Affected by Thyroid Dysfunction

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