Hyperthyroidism and Risk of Ischemic Stroke in Young Adults: A 5-Year Follow-Up Study
Abstract
BACKGROUND AND PURPOSE: Case reports or case series have reported the association between hyperthyroidism and cerebrovascular disease. However, hyperthyroidism has never been considered as a potential risk factor for stroke in young people. The aim of the present study is to estimate the risk for ischemic stroke among hyperthyroidism patients aged 18 to 44 years during a 5-year period after the diagnosis of hyperthyroidism as compared to a cohort of patients without hyperthyroidism during the same period. METHODS: A total of 3176 patients with hyperthyroidism were included as the study cohort and 25 408 patients without hyperthyroidism were included as comparison cohort. Each patient was individually tracked for 5 years from their index ambulatory visit to identify those in whom ischemic stroke developed. Cox proportional hazard regressions were performed to compute the 5-year stroke-free survival rate between these 2 cohorts. RESULTS: Of the total sample of 28 584 patients, 198 patients (0.7%) had ischemic strokes during the 5-year follow-up period (31 [1.0% of the hyperthyroidism patients] from the study cohort and 167 [0.6% of comparison patients] from the comparison cohort). After adjusting for the patient's age, gender, income, level of urbanization, hypertension, diabetes, atrial fibrillation, hyperlipidemia, coronary heart disease, and whether they were using antiarrhythmics, the hazard of having ischemic stroke during the 5-year follow-up period was 1.44-times greater (95% CI, 1.02-2.12; P=0.038) for patients with hyperthyroidism than for patients in the comparison cohort. CONCLUSIONS: We conclude that hyperthyroidism is associated with an increased risk for ischemic stroke among young adults.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The risk of ischemic stroke is 44% higher in adults with hyperthyroidism than in euthyroid controls.
“The risk of ischemic stroke is enhanced by 44% in adults with hyperthyroidism compared with euthyroid controls(78).”
From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [78]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Adams, H. P., Bendixen, B. H., Kappelle, L. J., Biller, J., Love, B. B., Gordon, D., & Marsh, E. E. (1993) · Stroke · doi:10.1161/01.str.24.1.35 · Cited by 12,350 · see citing works
Hollowell, J. G., Staehling, N. W., Flanders, W. D., Hannon, W. H., Gunter, E. W., Spencer, C. A., & Braverman, L. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.87.2.489 · Cited by 4,279 · see citing works
Primary Prevention of Ischemic Stroke
Goldstein, L. B., Adams, R. J., Alberts, M. J., Appel, L. J., Brass, L. M., Bushnell, C., Culebras, A., DeGraba, T. J., Gorelick, P. B., Guyton, J. R., et al. (2006) · Stroke · doi:10.1161/01.str.0000223048.70103.f1 · Cited by 1,359 · see citing works
Analysis of 1008 Consecutive Patients Aged 15 to 49 With First-Ever Ischemic Stroke
Jukka Putaala, A., Metso, A. J., Metso, T. M., Konkola, N., Kraemer, Y., Haapaniemi, E., Kaste, M., & Tatlisumak, T. (2009) · Stroke · doi:10.1161/strokeaha.108.529883 · Cited by 796 · see citing works
Taiwan’s New National Health Insurance Program: Genesis And Experience So Far
Cheng, T.-M. (2003) · Health Affairs · doi:10.1377/hlthaff.22.3.61 · Cited by 698 · see citing works
Mortality after the Treatment of Hyperthyroidism with Radioactive Iodine
Franklyn, J. A., Maisonneuve, P., Sheppard, M. C., Betteridge, J., & Boyle, P. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803123381103 · Cited by 308 · see citing works
Cerebral infarction in young adults
Kittner, S. J., Stern, B. J., Wozniak, M. A., et al. (1998) · Neurology · doi:10.1212/wnl.50.4.890 · Cited by 255 · see citing works
Thyroid Diseases and Cerebrovascular Disease
Squizzato, A., Gerdes, V. E. A., Brandjes, D. P. M., Büller, H. R., & Stam, J. (2005) · Stroke · doi:10.1161/01.str.0000181772.78492.07 · Cited by 236 · see citing works
Thyroid Dysfunction and Effects on Coagulation and Fibrinolysis: A Systematic Review
Squizzato, A., Romualdi, E., Buller, H. R., & Gerdes, V. E. A. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0199 · Cited by 222 · see citing works
Etiologic Study of Young Ischemic Stroke in Taiwan
Lee, T.-H., Hsu, W., Chen, C.-J., & Chen, S. (2002) · Stroke · doi:10.1161/01.str.0000021409.16314.16 · Cited by 214 · see citing works
Familial History of Stroke and Stroke Risk
Liao, D., Myers, R. H., Hunt, S. C., et al. (1997) · Stroke · doi:10.1161/01.str.28.10.1908 · Cited by 208 · see citing works
The thyroid epidemiology, audit, and research study: thyroid dysfunction in the general population
Flynn, R. W. V., MacDonald, T. M., Morris, A. D., Jung, R. T., & Leese, G. P. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-032089 · Cited by 196 · see citing works
Thyroid Function and Carotid Wall Thickness
Völzke, H., Robinson, D. M., Schminke, U., Lüdemann, J., Rettig, R., Felix, S. B., Kessler, C., John, U., & Meng, W. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031028 · Cited by 151 · see citing works
Increased Cardiovascular and Cancer Mortality after Radioiodine Treatment for Hyperthyroidism
Metso, S., Jaatinen, P., Huhtala, H., Auvinen, A. P., Oksala, H., & Salmi, J. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-2321 · Cited by 148 · see citing works
Blood coagulation and fibrinolysis in patients with hyperthyroidism
Erem, C., Ersöz, H. Ö., Karti, S. S., Ükinç, K., Hacıhasanoğlu, A., Değer, O., & Telatar, M. (2002) · Journal of Endocrinological Investigation · doi:10.1007/bf03344016 · Cited by 142 · see citing works
Smoking and Other Lifestyle Factors and the Risk of Graves’ Hyperthyroidism
Holm, I. A., Manson, J. E., Michels, K. B., Alexander, E. K., Willett, W. C., & Utiger, R. D. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.14.1606 · Cited by 140 · see citing works
Cardiovascular Manifestations of Hyperthyroidism Before and After Antithyroid Therapy
Osman, F., Franklyn, J. A., HOLDER, R. L., Sheppard, M. C., & GAMMAGE, M. D. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.08.042 · Cited by 137 · see citing works
Altered Platelet Plug Formation in Hyperthyroidism and Hypothyroidism
Homoncik, M., Gessl, A., Ferlitsch, A., Jilma, B., & Vierhapper, H. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-2644 · Cited by 122 · see citing works
Völzke, H., Schwahn, C., Wallaschofski, H., & Dörr, M. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0179 · Cited by 120 · see citing works
Lee, Y., Lin, R. S., Sung, F. C., Yang, C.-Y., Chien, K., Chen, W., Su, T., Hsu, H.-C., & Huang, Y.-C. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00198-0 · Cited by 113 · see citing works
A case series of young stroke in Rome
Rasura, M., Spalloni, A., Ferrari, M., et al. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01159.x · Cited by 105 · see citing works
Increased stiffness in common carotid artery in hyperthyroid Graves’ disease patients
Inaba, M., Henmi, Y., Kumeda, Y., Ueda, M., Nagata, M., Emoto, M., Ishikawa, T., Ishimura, E., & Nishizawà, Y. (2002) · Biomedicine & Pharmacotherapy · doi:10.1016/s0753-3322(02)00195-6 · Cited by 63 · see citing works
Coagulation and fibrinolysis in thyroid dysfunction
Erem, C. (2009) · Endocrine · doi:10.1007/s12020-009-9185-z · Cited by 47 · see citing works
Thyroid disease and its treatment: short-term and long-term cardiovascular consequences
Osman, F. (2001) · Current Opinion in Pharmacology · doi:10.1016/s1471-4892(01)00107-2 · Cited by 38 · see citing works
Qureshi, A. I., Suri, F. K., Nasar, A., Kirmani, J. F., Divani, A. A., & Giles, W. H. (2006) · PubMed · Cited by 32 · see citing works
Recent developments in hyperthyroidism
Kharlip, J., & Cooper, D. S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61047-3 · Cited by 27 · see citing works
Werthessen, N. T., Gargill, S. L., BERMAN, S., et al. (1945) · Endocrinology · doi:10.1210/endo-36-2-110 · Cited by 10 · see citing works
Hyperthyroidism and Risk of Atrial Fibrillation or Flutter: A Population-Based Study
Frost, L., Vestergaard, P., & Mosekilde, L. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.15.1675
Flagged first, then by citations
Research works printed but not linked: 1
- Osman F, Franklyn JA, Holder RL, Sheppard MC, Gammage MD. Car- diovascular manifestations of hyperthyroidism before and after anti- thyroid therapy: a matched case-control study. J Am Coll Cardiol. 2007; 49:71-81.
Cited by
Sorted by citations
Thyroid Hormones and Cardiovascular Function and Diseases
Razvi, S., Jabbar, A., Pingitore, A., Danzi, S., Biondi, B., Klein, I., Peeters, R., Zaman, A., & Iervasi, G. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.02.045 · Cited by 515 · see citing works
A critical review and meta-analysis of the association between overt hyperthyroidism and mortality
Brandt, F., Green, A., Hegedüs, L., & Brix, T. H. (2011) · European Journal of Endocrinology · doi:10.1530/eje-11-0299 · Cited by 170 · see citing works
The influence of thyroid function on the coagulation system and its clinical consequences
Elbers, L. P. B., Fliers, E., & Cannegieter, S. C. (2018) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.13970 · Cited by 123 · see citing works
Brandt, F., Almind, D., Christensen, K., Green, A., Brix, T. H., & Hegedüs, L. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2268 · Cited by 83 · see citing works
Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis
Chaker, L., Baumgartner, C., Ikram, M. A., Dehghan, A., Medici, M., Visser, W. E., Hofman, A., Rodondi, N., Peeters, R. P., & Franco, O. H. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-014-9946-8 · Cited by 72 · see citing works
Sohn, S. Y., Lee, E., Lee, M. K., & Lee, J. H. (2020) · Endocrinology and Metabolism · doi:10.3803/enm.2020.728 · Cited by 60 · see citing works
Pharmacodynamic and Therapeutic Actions of Levothyroxine
Hennessey, J. V. (2021) · 70 Years of Levothyroxine · doi:10.1007/978-3-030-63277-9_3 · Cited by 4 · see citing works
- Authors
- Sheu, J.-J., Kang, J.-H., Lin, H.-C., & Lin, H.-C.
- Affiliations
- Taipei Medical University Hospital (TW)
- Venue
- Stroke
- Published
- 2010-05
- Volume
- 41
- Issue
- 5
- Pages
- 961-966
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2109587419
- Cited by
- 104
- References
- 28
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 7 · 2017: 6 · 2016: 6 · 2015: 8 · 2014: 14 · 2013: 4 · 2012: 6
- FWCI
- 5.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Taipei Medical University Repository (submittedVersion)
- Funders
- National Health Research Institutes
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- hyperthyroidism, ischemic stroke, stroke risk, young adults, stroke-free survival, cerebrovascular disease, thyroid dysfunction
- MeSH terms
- Adolescent, Adult, Age Factors, Brain Ischemia, Female, Follow-Up Studies, Humans, Hyperthyroidism, Longitudinal Studies, Male, Prospective Studies, Risk Factors, Taiwan, Cohort Studies, Databases, Factual, Stroke, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
