Initial thyroid status and cardiovascular risk factors: The EPIC‐Norfolk prospective population study
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Summary: Context Thyroid status affects several aspects of cardiovascular risk profile, including lipid levels and blood pressure. Whether thyroid status affects the risk of coronary heart disease (CHD) and all‐cause mortality remains controversial. Design The EPIC‐Norfolk prospective population study. Mean follow‐up was 10·6 years. Patients Study participants were 11 554 men and women aged 45–79 years, who were living in Norfolk, UK. Measurements Baseline cardiovascular risk factors were recorded and concentrations of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) were measured in baseline samples. Regression analyses were performed to assess the association between thyroid hormone levels and cardiovascular risk factors. A proportional hazards model was used to estimate the risk of CHD and all‐cause mortality by baseline thyroid status. No information was available on thyroid treatment during follow‐up. Results Thyroid abnormalities were common, particularly among women. Thyroid abnormalities were associated with an altered cardiovascular risk profile. Even within the normal range, thyroid hormone levels, TSH more strongly than FT4, were associated with lipid levels and blood pressure among both men and women. We did not observe a significant association between subclinical thyroid abnormalities and risk of CHD or all‐cause mortality. Conclusions Despite the association between thyroid hormone levels and cardiovascular risk factors, thyroid status was not statistically significantly associated with the risk of future CHD or all‐cause mortality in this large cohort.
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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 [94]
Some studies report increased overall mortality rates in SH subjects, especially older subjects, while others indicate no relation.
“Some studies report increased overall mortality rates in SH subjects (374,379-383), especially older subjects, while others indicate no relation (384)(385)(386)(387).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [387]
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- Authors
- Boekholdt, S. M., Titan, S. M., Wiersinga, W. M., Chatterjee, K., Basart, D. C. G., Luben, R., Wareham, N. J., & Khaw, K.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- University of Cambridge (GB)
- Westfriesgasthuis (NL)
- MRC Epidemiology Unit (GB)
- Corresponding author
- Boekholdt, S. Matthijs
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2010-02-10
- Volume
- 72
- Issue
- 3
- Pages
- 404-410
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2145924439
- Cited by
- 167
- References
- 30
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 10 · 2022: 8 · 2021: 9 · 2020: 7 · 2019: 12 · 2018: 16 · 2017: 17 · 2016: 14 · 2015: 11 · 2014: 14 · 2013: 19 · 2012: 11
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Wellcome Trust
- Cancer Research UK
- British Heart Foundation
- Stroke Association
- 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
- thyroid function, thyroid-stimulating hormone, free thyroxine, subclinical thyroid dysfunction, cardiovascular risk factors, coronary artery disease, all-cause mortality, serum lipids, blood pressure, EPIC-Norfolk cohort
- MeSH terms
- Aged, Coronary Disease, England, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Thyroid Diseases, Thyroid Gland, Thyroid Hormones
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