Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study)
Open accessAbstract
Background Hyperthyroidism has a well-described association with atrial fibrillation (AF). However, the relation of hypothyroidism to AF has had limited investigation. Hypothyroidism is associated with cardiovascular risk factors, subclinical cardiovascular disease, and overt cardiovascular disease, all of which predispose to AF. We investigated 10-year incidence of AF in a community-dwelling cohort.Methods Among 6,653 Framingham heart Study participants, 5,069 participants, 52% female, with mean age of 57 ± 12 years, were eligible after excluding those with missing thyroid-stimulating hormone (TSH), TSH <0.45 μU/L (hyperthyroid), TSH >19.9 μU/L, or prevalent AF. Thyroid-stimulating hormone was categorized by range (≥0.45 to <4.5, 4.5 to <10.0, 10.0 to ≤19.9 μU/L) and by quartiles. We examined the associations between TSH and 10-year risk of AF using multivariable-adjusted Cox proportional hazards analysis.Results Over 10-year follow-up, we observed 277 cases of incident AF. A 1-SD increase in TSH was not associated with increased risk of AF (hazard ratio 1.01, 95% CI 0.90-1.14, P = .83). In categorical analysis, using TSH ≥0.45 to <4.5 μU/L as the referent (equivalent to euthyroid state), we found no significant association between hypothyroidism and 10-year AF risk. Comparing the highest (2.6 < TSH < 19.9 μU/L) to lowest (0.45 < TSH < 1.3 μU/L) quartiles of TSH further did not identify a significant association between TSH levels and 10-year risk of AF.Conclusions In conclusion, we did not identify a significant association between hypothyroidism and 10-year risk of incident AF in a community-based study.
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Thyroid dysfunction is independently associated with AF, with hypothyroidism HR 1.23, subclinical hyperthyroidism RR 1.31, and overt hyperthyroidism RR 1.42 compared with euthyroid.
“Thyroid dysfunction 206, 207 hypothyroidism subclinical hyperthyroidism overt hyperthyroidism (reference: euthyroid) HR 1.23 (95% CI 0.77-1.97)RR 1.31 (95% CI 1.19-1.44)RR 1.42 (95% CI 1.22-1.63)”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [207]
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- Authors
- Kim, E.-J., Lyass, A., Wang, N., Massaro, J. M., Fox, C. S., Benjamin, E. J., & Magnani, J. W.
- Affiliations
- Boston University (US)
- Corresponding author
- Magnani, Jared W.
- ORCID
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 167
- Issue
- 1
- Pages
- 123-126
- ISSN
- 0002-8703 (ISSN-L)
- PMC
- PMC3868014
- OpenAlex
- W2074348266
- Cited by
- 80
- References
- 33
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 2 · 2023: 8 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 7 · 2018: 6 · 2017: 7 · 2016: 11 · 2015: 3 · 2014: 5 · 2013: 1
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1r03ag045075-01, n01hc25195-41-0-1)
- National Institute on Aging (R03-AG045075, R01AG028321)
- National Heart, Lung, and Blood Institute (N01‐HC25195, R01HL102214, N01-HC-025195, HL092577, Z01HL001056, RC1HL101056, R01HL092577)
- National Institute of Neurological Disorders and Stroke (6R01NS17950, R01NS017950)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- hypothyroidism, atrial fibrillation, thyroid-stimulating hormone, hyperthyroidism, incident atrial fibrillation risk, thyroid function, cardiovascular risk factors, Framingham Heart Study
- MeSH terms
- Adult, Atrial Fibrillation, Female, Humans, Hypothyroidism, Male, Middle Aged, Risk Factors, Thyrotropin, Cohort Studies, Comorbidity, Proportional Hazards Models
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