Issue: August 2016
June 29, 2016
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Long-term levothyroxine therapy does not affect arterial stiffness, central hemodynamics

Issue: August 2016
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Researchers found no adverse effects on arterial stiffness or central hemodynamics in patients treated with long-term levothyroxine replacement therapy to target thyroid-stimulating hormone in the reference range.

Esben Laugesen, MD, PhD, of the department of endocrinology and internal medicine at Aarhus University Hospital in Denmark, and colleagues evaluated 30 adults (mean age, 54.5 years; 80% women) who underwent thyroidectomy between 1971 and 2009 and who were on long-term (median, 11 years) levothyroxine replacement therapy targeting TSH in the reference range. Researchers also evaluated 30 age- and sex-matched controls for comparison.

Carotid-femoral pulse wave velocity (PWV) was used to evaluate arterial stiffness and pulse wave analysis using the SphygmoCor system (AtCor Medical) was used to evaluate central hemodynamics.

Compared with controls, participants on levothyroxine had lower plasma triiodothyronine (P = .04) and higher thyroxine (P < .001); there was no difference between the groups for TSH levels.

The PWV and pulse wave analysis indexes of aortic systolic and diastolic blood pressure, augmentation index and pulse pressure amplification did not significantly differ between the two groups. No link existed between the PWV and pulse wave analysis indexes and TSH, T3, T4 and the T4/T3 ratio.

“Long-term TSH-suppressive [levothyroxine] replacement therapy has been associated with increased arterial stiffness and increased [cardiovascular] mortality,” the researchers wrote. “We investigated patients treated with long-term [levothyroxine] replacement therapy targeting TSH in the reference range and found no indications of adverse effects on arterial stiffness and central hemodynamics.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.