Background Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension.
Methods Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017.
Results The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years.
Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
Citations
Citations to this article as recorded by
Systematic review and meta-analysis of levothyroxine effect on blood pressure in patients with subclinical hypothyroidism Bahar Darouei, Reza Amani-Beni, Amir Parsa Abhari, Mohammad Fakhrolmobasheri, Davood Shafie, Maryam Heidarpour Current Problems in Cardiology.2024; 49(2): 102204. CrossRef
Gender-Specific Associations Between Metabolic Disorders and Thyroid Nodules: A Cross-Sectional Population-Based Study from China Fan Zhang, Di Teng, Nanwei Tong, Guixia Wang, Yongze Li, Xiaohui Yu, Zhongyan Shan, Weiping Teng Thyroid.2022; 32(5): 571. CrossRef
Effect of Levothyroxine Supplementation on the Cardiac Morphology and Function in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis Xichang Wang, Haoyu Wang, Qiuxian Li, Ping Wang, Yumin Xing, Fan Zhang, Jiashu Li, Zhongyan Shan The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): 2674. CrossRef
Innumerable studies have suggested “the lower, the better” for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.
Citations
Citations to this article as recorded by
Sex Differences in Low-Density Lipoprotein Cholesterol Treatment Among Young Israeli Patients Following Premature Acute Coronary Syndrome Feras Haskiah, Karam Abdelhai, Ranin Hilu, Abid Khaskia Metabolic Syndrome and Related Disorders.2024;[Epub] CrossRef
Long-term variability in physiological measures in relation to mortality and epigenetic aging: prospective studies in the USA and China Hui Chen, Tianjing Zhou, Shaowei Wu, Yaying Cao, Geng Zong, Changzheng Yuan BMC Medicine.2023;[Epub] CrossRef
Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee Endocrinology and Metabolism.2023; 38(1): 10. CrossRef
Relationship between Short- and Mid-Term Glucose Variability and Blood Pressure Profile Parameters: A Scoping Review Elena Vakali, Dimitrios Rigopoulos, Petros C. Dinas, Ioannis-Alexandros Drosatos, Aikaterini G. Theodosiadi, Andriani Vazeou, George Stergiou, Anastasios Kollias Journal of Clinical Medicine.2023; 12(6): 2362. CrossRef
Lipid treatment status and goal attainment among patients with premature acute coronary syndrome in Israel Feras Haskiah, Abid Khaskia Journal of Clinical Lipidology.2023; 17(3): 367. CrossRef
Research on obesity using the National Health Information Database: recent trends Eun-Jung Rhee Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35. CrossRef
Risk of fracture according to temporal changes of low body weight changes in adults over 40 years: a nationwide population-based cohort study Jung Guel Kim, Jae-Young Hong, Jiwon Park, Sang-Min Park, Kyungdo Han, Ho-Joong Kim, Jin S. Yeom BMC Public Health.2023;[Epub] CrossRef
Factors Affecting High Body Weight Variability Kyungdo Han, Mee Kyoung Kim Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163. CrossRef
Puerarin Attenuates High-Glucose and High-Lipid-Induced Inflammatory Injury in H9c2 Cardiomyocytes via CAV3 Protein Upregulation YiFu Tian, CaiXia Zhou, XiaoYang Bu, Qian Lv, Qin Huang Journal of Inflammation Research.2023; Volume 16: 2707. CrossRef
Visit-to-Visit Glucose Variability, Cognition, and Global Cognitive Decline: The Multi-Ethnic Study of Atherosclerosis Christopher L Schaich, Michael P Bancks, Kathleen M Hayden, Jingzhong Ding, Stephen R Rapp, Alain G Bertoni, Susan R Heckbert, Timothy M Hughes, Morgana Mongraw-Chaffin The Journal of Clinical Endocrinology & Metabolism.2023; 109(1): e243. CrossRef
Association between lipid variability and the risk of mortality in cancer patients not receiving lipid-lowering agents Seohyun Kim, Gyuri Kim, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim Frontiers in Oncology.2023;[Epub] CrossRef
The Association of Postprandial Triglyceride Variability with Renal Dysfunction and Microalbuminuria in Patients with Type 2 Diabetic Mellitus: A Retrospective and Observational Study Natsumi Matsuoka-Uchiyama, Haruhito A. Uchida, Shugo Okamoto, Yasuhiro Onishi, Katsuyoshi Katayama, Mariko Tsuchida-Nishiwaki, Hidemi Takeuchi, Rika Takemoto, Yoshiko Hada, Ryoko Umebayashi, Naoko Kurooka, Kenji Tsuji, Jun Eguchi, Hirofumi Nakajima, Kenic Journal of Diabetes Research.2022; 2022: 1. CrossRef
Associations of variability in body weight and glucose levels with the risk of hip fracture in people with diabetes Jeongmin Lee, Kyungdo Han, Sang Hyun Park, Mee Kyoung Kim, Dong-Jun Lim, Kun-Ho Yoon, Moo-Il Kang, Seung-Hwan Lee Metabolism.2022; 129: 155135. CrossRef
The Influence of Obesity and Metabolic Health on Vascular Health Eun-Jung Rhee Endocrinology and Metabolism.2022; 37(1): 1. CrossRef
Variability of Metabolic Risk Factors: Causative Factor or Epiphenomenon? Hye Jin Yoo Diabetes & Metabolism Journal.2022; 46(2): 257. CrossRef
Changes in Underweight Status and Risk of Hip Fracture: A Korean Nationwide Population-Based Cohort Study Sangsoo Han, Jiwon Park, Hae-Dong Jang, Kyungdo Han, Choungah Lee, Wonseok Kim, Jae-Young Hong Journal of Clinical Medicine.2022; 11(7): 1913. CrossRef
Dynamic physical examination indicators of cardiovascular health: A single-center study in Shanghai, China Rongren Kuang, Yiling Liao, Xinhan Xie, Biao Li, Xiaojuan Lin, Qiang Liu, Xiang Liu, Wenya Yu, Yajing Wang PLOS ONE.2022; 17(5): e0268358. CrossRef
Characteristics and Clinical Course of Diabetes of the Exocrine Pancreas: A Nationwide Population-Based Cohort Study Nami Lee, So Jeong Park, Dongwoo Kang, Ja Young Jeon, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Edward J. Boyko, Seung Jin Han Diabetes Care.2022; 45(5): 1141. CrossRef
Lipid Variability and Risk of Cardiovascular Diseases and All-Cause Mortality: A Systematic Review and Meta-Analysis of Cohort Studies Shuting Li, Leying Hou, Siyu Zhu, Qian Yi, Wen Liu, Yang Zhao, Feitong Wu, Xue Li, An Pan, Peige Song Nutrients.2022; 14(12): 2450. CrossRef
Impact of Visit-to-Visit Triglyceride-Glucose Index Variability on the Risk of Cardiovascular Disease in the Elderly Fei Chen, Ying Pan, Ziqing Liu, Rong Huang, Jing Wang, Jian Shao, Yaqin Gong, Xiyi Sun, Xiaobo Jiang, Weihao Wang, Zhaoqiang Li, Shao Zhong, Qi Pan, Kaixin Zhou, Muhammad Furqan Akhtar International Journal of Endocrinology.2022; 2022: 1. CrossRef
Fenofibrate add-on to statin treatment is associated with low all-cause death and cardiovascular disease in the general population with high triglyceride levels Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park Metabolism.2022; 137: 155327. CrossRef
Mean versus variability of lipid measurements over 6 years and incident cardiovascular events: More than a decade follow-up Soroush Masrouri, Leila Cheraghi, Niloofar Deravi, Neda Cheraghloo, Maryam Tohidi, Fereidoun Azizi, Farzad Hadaegh Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Long-Term Variability in Physiological Measures in Relation to Mortality and Epigenetic Aging: Prospective Studies in the US and China Hui Chen, Tianjing Zhou, Shaowei Wu, Yaying Cao, Geng Zong, Changzheng Yuan SSRN Electronic Journal .2022;[Epub] CrossRef
Acute Glucose Shift Induces the Activation of the NLRP3 Inflammasome in THP-1 Cells Ji Yeon Lee, Yup Kang, Hae Jin Kim, Dae Jung Kim, Kwan Woo Lee, Seung Jin Han International Journal of Molecular Sciences.2021; 22(18): 9952. CrossRef
Body Weight Change and Cardiovascular Disease: Effect of Weight Gain, Weight Loss, and Weight Cycling Jung-Hwan Cho, Eun-Jung Rhee, Won-Young Lee Cardiovascular Prevention and Pharmacotherapy.2021; 3(4): 73. CrossRef
Fasting Glucose Variability as a Risk Indicator for End-Stage Kidney Disease in Patients with Diabetes: A Nationwide Population-Based Study Da Young Lee, Jaeyoung Kim, Sanghyun Park, So Young Park, Ji Hee Yu, Ji A. Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Kyungdo Han, Nan Hee Kim Journal of Clinical Medicine.2021; 10(24): 5948. CrossRef
Characteristics and Clinical Course of Diabetes of the Exocrine Pancreas: A Nationwide Population-Based Cohort Studybrief Title: Diabetes of the Exocrine Pancreas Nami Lee, So Jeong Park, Dongwoo Kang, Ja Young Jeon, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Edward J. Boyko, Seung Jin Han SSRN Electronic Journal .2021;[Epub] CrossRef
Validation of a wearable cuff-less wristwatch-type blood pressure monitoring device Joon Ho Moon, Myung-Kyun Kang, Chang-Eun Choi, Jeonghee Min, Hae-Young Lee, Soo Lim Scientific Reports.2020;[Epub] CrossRef
To test the hypothesis that hyperinsulinemia and/or abnormalities of red cell membrane Na^+ transport are concerned in the pathogenesis of hypertension, we investigated the relationship between blood pressure, insulin level and red cell membrane Na^+ transport in patients with acromegaly which is frequently associated with hypertension, hyperinsulinemia and abnormalities of red cell membrane Na^+ transport.The results were as follows;1) BMI and both systolic and diastolic blood pressure were significantly higher in patients with acromegaly than in control subjects.2) Fasting glucose and insulin levels were higher, and both serum glucose and insulin responses after a 75g glucose load were significantly increased in patients with acromegaly as compared with control subjects.3) Vmax of Na^+-Li^+ countertransport were significantly higher in patients with acromegaly than in control subjects while red cell Na^+ concentration and Vmax of Na^+, K^+ ATPase were similar in the two groups.4) In multiple stepwise regression analysis, age was directly correlated with both systolic and diastolic blood pressure in acromegaly. On the other hand both insulin level and red cell membrane Na^+ transport showed little correlation with either systolic or diastolic pressure. 5) Prevalence of hypertension in acromegaly was 39%(9 out of 23) and only age except for blood pressure was significantly higher in hypertensive acromegalic patients than in normotensive acromegalic patients while GH level, insulin levels and red cell membrane Na^+ transport were similar in the two groupsThese results suggest that hyperinsulinemia or abnormalities of red cell membrane Na^+ transport are not causally related to hypertension in patients with acromegaly.