Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico

Ferreira, Márcia Martins; Teixeira, Patrícia de Fátima dos Santos; Mansur, Vera Aleta R; Reuters, Vaneska Spinelli; Almeida, Cloyra

doi:10.1590/s0066-782x2010005000040

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…This result is in accordance with the hypothesis that SCH leads to atherosclerosis by augmenting classical CV risk factors such as dyslipidaemia and systemic hypertension (6). Indeed, positive correlations between serum TSH and blood pressure (35,36) and between TSH and serum lipids (2, 37, 38) have been demonstrated in several studies. In addition, a potential relationship between SCH and metabolic syndrome and a reduction in insulin sensitivity have also been proposed (39,40), and SCH also seems to be associated with additional CV risk factors.…”

Section: Discussionsupporting

confidence: 89%

Subclinical hypothyroidism represents an additional risk factor for coronary artery calcification, especially in subjects with intermediate and high cardiovascular risk scores

Silva¹,

Santos²,

Morais³

et al. 2014

European Journal of Endocrinology

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Objective: Several studies have suggested an association between subclinical hypothyroidism (SCH) and increased cardiovascular risk. The aim of this study was to evaluate the presence of coronary artery disease (CAD) in asymptomatic patients with SCH by measuring the coronary artery calcium score (CACS). Design: A total of 222 asymptomatic subjects (103 SCH and 119 euthyroid (EU)), who were between the ages of 35 and 65 years and had no previous history of CAD, were enrolled for this cross-sectional analysis. Methods: The criteria for SCH included a confirmed normal serum free thyroxine and high TSH levels. Lipid profile, Framingham risk score (FRS) and CACS analyses were performed for all subjects. Results: The SCH and EU groups were comparable with respect to age, gender, BMI and frequency of diabetes, systemic arterial hypertension, hypercholesterolaemia and smoking. There was no difference in the median CACS between the SCH and EU groups. However, in the subgroup of subjects with intermediate/high FRS (AR 10y R10%), CACS was higher in the SCH subjects compared with EU subjects (EU vs SCH, 0.0 (57.0) vs 23.0 (161.5); PZ0.045). Multivariate analysis revealed that the risk for CACS O100 was independently associated with male gender, age O55 years, and the presence of simultaneous SCH and AR 10y R10% (ORZ87.5 (CIZ2.1-3500); PZ0.001). Serum TSH was positively correlated with CACS, especially in intermediate/high FRS subjects (r s Z0.301, PZ0.045). Conclusions: It was demonstrated that SCH represents an additional risk factor for CAD, notably in intermediate and high FRS subjects.

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Section: Discussionsupporting

confidence: 89%

Subclinical hypothyroidism represents an additional risk factor for coronary artery calcification, especially in subjects with intermediate and high cardiovascular risk scores

Silva¹,

Santos²,

Morais³

et al. 2014

European Journal of Endocrinology

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“…The analyses were exploratory, and findings should be confirmed for subjects in different districts and for different populations of subjects. In addition, the observed indicators in our study were relationships between thyroid function and clinic blood pressure, others studies had shown both overt and subclinical hypothyroidism were not only associated with the clinic blood pressure but also related to ambulatory blood pressure [28][29][30]. To the best of our knowledge, few studies have been performed to examine the relationship of blood pressure to thyroid function in children and adolescents.…”

Section: Discussionsupporting

confidence: 61%

Investigation of thyroid function and blood pressure in school-aged subjects without overt thyroid disease

Chen

Zhang

et al. 2011

Endocrine

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This study was performed to ascertain whether a relationship exists between thyroid function and blood pressure in school-aged Chinese subjects without overt thyroid disease. A cross-sectional survey of 880 subjects (541 females and 339 males) aged 7-18 years in Bengbu, Anhui province was conducted. The investigation, which was based on a stratified random cluster sampling method, included a questionnaire and measurements of blood pressure, height, and body weight. Fasting blood samples were taken for measurements of thyroid-stimulating hormone (TSH), free 3,5,3'-triiodothyronine (FT(3)) and free thyroxine (FT(4)). Serum TSH and FT(3) were positively correlated with systolic and diastolic blood pressure Z scores (SBP-Z and DBP-Z) even after adjusting for body mass index (BMI) (P < 0.05) but no correlation was observed between FT(4) and SBP-Z or DBP-Z after comparable adjustments (P > 0.05). SBP-Z and DBP-Z in subjects with subclinical hypothyroidism were significant higher than in euthyroid subjects (P < 0.05). Both SBP-Z and DBP-Z increased linearly with TSH concentration in boys after adjusting BMI (P < 0.05); however, a similar linear trend was not observed in girls. Our findings support the hypothesis that elevated TSH and FT(3) concentrations increase blood pressure in school-aged Chinese subjects without overt thyroid disease; this increase may be even more significant in boys.

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“…Additionally, we evaluated the effect of Hy on blood pressure, since thyroid dysfunction is associated with alterations in the systolic and/or diastolic pressures 4,18,31 . The measurements showed a higher SBP in the HG.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, most studies have focused on the abnormalities of cardiac and blood vessel function in the presence of hypo and hyperthyroidism (Hy). In general, TH increase basal metabolism and oxygen consumption acting directly on the heart and blood vessels 1-4 . Clinical and experimental evaluation are often based on the demonstration of an increase in myocardial contractility and heart rate (HR) on the one side and reduced peripheral vascular total resistance (PVTR) followed by a decrease in cardiac efficiency in the long run on the other side.…”

Section: Introdutionmentioning

confidence: 99%

Short-Term Thyroid Hormone Excess Affects the Heart but Does not Affect Adrenal Activity in Rats

Szkudlarek¹,

Aldenucci²,

Miyagui³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundHyperthyroidism (Hy) exerts a broad range of influences on a variety of physiological parameters. Its disruptive effect on cardiovascular system is one of its most remarkable impacts. Moreover, Hy has been clinically associated with stress - induced hyperactivation of the hypothalamic-pituitary-adrenal axis.ObjectiveEvaluate the impact of short-term Hy on cardiac performance and adrenal activity of rats.MethodsInduction of Hy in Wistar rats through injections of T3 (150 µg/kg) for 10 days (hyperthyroid group - HG) or vehicle (control group). The cardiovascular performance was evaluated by: echocardiography (ECHO); heart weight/body weight (mg/gr) ratio; contractility of isolated papillary muscles (IPM) and direct measurement of blood pressures. Adrenal activity was evaluated by adrenal weight/body weight (mg/gr) ratio and 24-hour fecal corticosterone (FC) levels on the, 5th and 10th days of T3 treatment.ResultsIn HG, the ECHO showed reduction of the End Systolic and End Diastolic Volumes, Ejection, Total Diastolic and Isovolumic Relaxation Times, Diastolic and Systolic Areas and E/A ratio. Heart Rate, Ejection Fraction and Cardiac Output increased. The heart weight/body weight ratio was higher. Similarly, in IPM, the maximum rate of force decay during relaxation was higher in all extracellular calcium concentrations. Systolic blood pressure (SBP) levels were higher. (p ≤ 0.05). On the other hand, there was no difference in the adrenal weight/body weight ratio or in the 24-hour FC levels.ConclusionsHy induces positive inotropic, chronotropic and lusitropic effects on the heart by direct effects of T3 and increases SBP. Those alterations are not correlated with changes in the adrenal activity.

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Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico

Abstract: Background: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH) with arterial blood pressure (ABP) alteration is unknown.

Cited by 10 publications

References 38 publications

Subclinical hypothyroidism represents an additional risk factor for coronary artery calcification, especially in subjects with intermediate and high cardiovascular risk scores

Subclinical hypothyroidism represents an additional risk factor for coronary artery calcification, especially in subjects with intermediate and high cardiovascular risk scores

Investigation of thyroid function and blood pressure in school-aged subjects without overt thyroid disease

Short-Term Thyroid Hormone Excess Affects the Heart but Does not Affect Adrenal Activity in Rats

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