OBJECTIVE:Subclinical hypothyroidism affects 5-15% of the general population, is especially prevalent in females, and may be associated with increased morbidity from cardiovascular disease, although it remains controversial. We recently reported a significant increase in the brachial-ankle pulse wave velocity (baPWV), a parameter of arterial stiffening and an independent predictor of cardiovascular events, in subclinical hypothyroidism without thyroiditis. The current study was performed to assess changes in baPWV in female subclinical hypothyroidism with autoimmune chronic thyroiditis (Hashimoto's disease) after restoration of normal thyroid function. METHODS: In a randomized placebo-controlled study, 95 female subclinical hypothyroid patients were monitored for changes in baPWV before and after levothyroxine (l-T(4)) replacement therapy. Changes in baPWV were also measured in 42 age-matched normal female subjects. RESULTS: The baseline baPWV values in patients with subclinical hypothyroidism were significantly higher than in normal subjects. With attainment of euthyroidism, baPWV showed a significant decrease from 1776.7+/-86.0 to 1674.3+/-79.2 cm/s (P=0.006) in patients treated with l-T(4), but the changes in baPWV and TSH were not correlated. The change in baPWV was significantly and negatively correlated with age and baseline pulse pressure, but multiple regression analysis revealed that these parameters failed to be associated with the change in baPWV. CONCLUSIONS: Sustained normalization of thyroid function during l-T(4) replacement therapy significantly decreases baPWV in female subclinical hypothyroid patients with autoimmune chronic thyroiditis, suggesting the improvement of arterial stiffening and, consequently, possible prevention of cardiovascular disease.
RCT Entities:
OBJECTIVE: Subclinical hypothyroidism affects 5-15% of the general population, is especially prevalent in females, and may be associated with increased morbidity from cardiovascular disease, although it remains controversial. We recently reported a significant increase in the brachial-ankle pulse wave velocity (baPWV), a parameter of arterial stiffening and an independent predictor of cardiovascular events, in subclinical hypothyroidism without thyroiditis. The current study was performed to assess changes in baPWV in female subclinical hypothyroidism with autoimmune chronic thyroiditis (Hashimoto's disease) after restoration of normal thyroid function. METHODS: In a randomized placebo-controlled study, 95 female subclinical hypothyroidpatients were monitored for changes in baPWV before and after levothyroxine (l-T(4)) replacement therapy. Changes in baPWV were also measured in 42 age-matched normal female subjects. RESULTS: The baseline baPWV values in patients with subclinical hypothyroidism were significantly higher than in normal subjects. With attainment of euthyroidism, baPWV showed a significant decrease from 1776.7+/-86.0 to 1674.3+/-79.2 cm/s (P=0.006) in patients treated with l-T(4), but the changes in baPWV and TSH were not correlated. The change in baPWV was significantly and negatively correlated with age and baseline pulse pressure, but multiple regression analysis revealed that these parameters failed to be associated with the change in baPWV. CONCLUSIONS: Sustained normalization of thyroid function during l-T(4) replacement therapy significantly decreases baPWV in female subclinical hypothyroidpatients with autoimmune chronic thyroiditis, suggesting the improvement of arterial stiffening and, consequently, possible prevention of cardiovascular disease.
Authors: Martin Feller; Marieke Snel; Elisavet Moutzouri; Douglas C Bauer; Maria de Montmollin; Drahomir Aujesky; Ian Ford; Jacobijn Gussekloo; Patricia M Kearney; Simon Mooijaart; Terry Quinn; David Stott; Rudi Westendorp; Nicolas Rodondi; Olaf M Dekkers Journal: JAMA Date: 2018-10-02 Impact factor: 56.272
Authors: Richard Birtwhistle; Kate Morissette; James A Dickinson; Donna L Reynolds; Marc T Avey; Francesca Reyes Domingo; Rachel Rodin; Brett D Thombs Journal: CMAJ Date: 2019-11-18 Impact factor: 8.262