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Cited by 503Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHormonal and reproductive studies

Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death

Rodondi, Nicolas, Newman, Anne B., Vittinghoff, Eric, de Rekeneire, Nathalie, Satterfield, Suzanne, Harris, Tamara B., Bauer, Douglas C.·2005·Archives of Internal Medicine
DOI 10.1001/archinte.165.21.2460
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Abstract

BACKGROUND: Subclinical hypothyroidism has been associated with systolic and diastolic cardiac dysfunction and an elevated cholesterol level, but data on cardiovascular outcomes and death are limited. METHODS: We studied 2730 men and women, aged 70 to 79 years, with baseline thyrotropin (TSH) measurements and 4-year follow-up data to determine whether subclinical hypothyroidism was associated with congestive heart failure (CHF), coronary heart disease, stroke, peripheral arterial disease, and cardiovascular-related and total mortality. After the exclusion of participants with abnormal thyroxine levels, subclinical hypothyroidism was defined as a TSH level of 4.5 mIU/L or greater, and was further classified according to TSH levels (4.5-6.9, 7.0-9.9, and > or = 10.0 mIU/L). RESULTS: Subclinical hypothyroidism was present in 338 (12.4%) of the participants. Compared with euthyroid participants, CHF events occurred more frequently among those with a TSH level of 7.0 mIU/L or greater (35.0 vs 16.5 per 1000 person-years; P = .006), but not among those with TSH levels between 4.5 and 6.9 mIU/L. In multivariate analyses, the risk of CHF was higher among those with high TSH levels (TSH of 7.0-9.9 mIU/L: hazard ratio, 2.58 [95% confidence interval, 1.19-5.60]; and TSH of > or = 10.0 mIU/L: hazard ratio, 3.26 [95% confidence interval, 1.37-7.77]). Among the 2555 participants without CHF at baseline, the hazard ratio for incident CHF events was 2.33 (95% confidence interval, 1.10-4.96; P = .03) in those with a TSH of 7.0 mIU/L or greater. Subclinical hypothyroidism was not associated with increased risk for coronary heart disease, stroke, peripheral arterial disease, or cardiovascular-related or total mortality. CONCLUSIONS: Subclinical hypothyroidism is associated with an increased risk of CHF among older adults with a TSH level of 7.0 mIU/L or greater, but not with other cardiovascular events and mortality. Further investigation is warranted to assess whether subclinical hypothyroidism causes or worsens preexisting heart failure.

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  • The association between subclinical hypothyroidism and cardiovascular disease or mortality has not been confirmed in all studies.

    “However, this relationship has not been confirmed in all studies (94,99,100).”

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [99]

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Authors
Rodondi, N., Newman, A. B., Vittinghoff, E., de Rekeneire, N., Satterfield, S., Harris, T. B., & Bauer, D. C.
Affiliations
University of California, San Francisco (US)
ORCID
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2005-11-28
Volume
165
Issue
21
Pages
2460
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.165.21.2460
OpenAlex
W2117664343
Cited by
503
References
50
Citations by year
2026: 8 · 2025: 11 · 2024: 18 · 2023: 13 · 2022: 13 · 2021: 17 · 2020: 17 · 2019: 18 · 2018: 25 · 2017: 25 · 2016: 27 · 2015: 23 · 2014: 43 · 2013: 40 · 2012: 52
FWCI
16.76
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
Funders
National Institute on Aging (N01‐AG‐6–2101, N01AG62106, N01-AG-62103)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
subclinical hypothyroidism, congestive heart failure, thyroid-stimulating hormone, cardiovascular risk, coronary artery disease, stroke, peripheral arterial disease, cardiovascular mortality, all-cause mortality, older adults, thyroid function
MeSH terms
Aged, Arterial Occlusive Diseases, Coronary Disease, Female, Follow-Up Studies, Heart Failure, Humans, Hypothyroidism, Immunoassay, Male, Prospective Studies, Risk Factors, Thyrotropin, Biomarkers, Survival Rate, Stroke

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