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Subclinical hypothyroidism linked with ischemic heart disease 20 years later

This association was more pronounced in women.

Issue: December 2007

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December 2007

NEW YORK — Researchers have found a positive association between subclinical hypothyroidism at baseline and incident ischemic heart disease and mortality after 20 years of follow-up, according to results of a study presented at the 78th Annual Meeting of the American Thyroid Association.

“The association between incident ischemic heart disease and ischemic heart disease–related mortality was statistically significant in women but not men,” Salman Razvi, MD, MRCP, consultant endocrinologist, Queen Elizabeth Hospital, Gateshead, United Kingdom, told Endocrine Today.

The data were reported after a reanalysis of the original 20-year Whickham study, which evaluated ischemic heart disease and mortality in patients stratified by thyroid function and thyroid antibody status. Original findings suggested no association between an autoimmune thyroid disease group and ischemic heart disease.

Association found

The researchers analyzed mortality and incident ischemic heart disease events in 95 patients with raised serum thyroid-stimulating hormone (>6.0 mIU/L) and normal thyroxine concentrations compared with 1,946 euthyroid participants.

At follow-up, incident ischemic heart disease was significantly higher in patients with subclinical hypothyroidism (HR=1.85; 95% CI, 1.25-2.75). In addition, patients with subclinical hypothyroidism also had a higher ischemic heart disease mortality rate (HR=2.0; 95% CI, 1.03-3.87). All-cause mortality between the two groups was similar (men, HR=1.2; 95% CI, 0.64-2.28; women, HR=1.23; 95% CI, 0.8-1.89).

The association between subclinical hypothyroidism and incident ischemic heart disease was more pronounced in women compared with men (HR=1.76; 95% CI, 1.14-2.71 vs. HR=1.23; 95% CI, 0.67-2.28). Findings were also similar for women with regard to ischemic heart disease mortality (HR=1.9; 95% CI, 1.04-3.8 vs. HR=1.14; 95% CI, 0.49-2.61).

“That is probably due to a higher number of women than men with subclinical hypothyroidism, giving the study higher power to detect an association for women,” Razvi said.

These results are consistent with findings from some other large, community-based surveys that examined this association, according to the researchers.

“We need to recognize subclinical hypothyroidism as being associated with morbidity and mortality due to ischemic heart disease. Interventional trials are required to investigate if outcomes are improved with treatment,” he said. – by Katie Kalvaitis

For more information:

• Razvi SS, Weaver J, Vanderpump MP, Pearce S. Incident ischemic heart disease and thyroid status: the Whickham cohort reevaluated. #89. Presented at: the 78th Annual Meeting of the American Thyroid Association; Oct. 3-7, 2007; New York.