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Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study
Abstract
CONTEXT: The association between thyroid function and blood pressure is insufficiently studied. OBJECTIVE: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. DESIGN AND SETTING: This was a cross-sectional, population-based study. SUBJECTS: A total of 30,728 individuals without previously known thyroid disease were studied. MAIN OUTCOME MEASURES: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (>140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. RESULTS: Within the reference range of TSH (0.50-3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4-2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4-2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2-2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8-1.3 mm Hg) in women. Comparing TSH of 3.0-3.5 mU/liter (upper part of the reference) with TSH of 0.50-0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56-2.53) in men and 1.23 (95% CI 1.04-1.46) in women. CONCLUSION: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.
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“Within the reference range of 0.50–3.5 mU/L, blood pressure increased linearly with increasing TSH (SBP by 2.0 mmHg in men and 1.8 mmHg in women, DBP increased by 1.6 and 1.1 mmHg) (101).”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [101]
In the citing paper
“For instance, comparing TSH of 3.0–3.5 mU/L with 0.50–0.99 mU/L, the OR for hypertension was 1.98 in men and 1.23 in women (101).”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [101]
In the citing paper
“In particular higher levels of TSH were associated with worsening of both blood pressure [58–60] and lipid levels [61, 62] although these effects were modest.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [59]
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Metadata
- Authors
- Åsvold, B. O., Bjøro, T., Nilsen, T. I. L., & Vatten, L. J.
- Affiliations
- Department of Public Health (B.O. Å., T.I.L.N., L.J.V.), Faculty of Medicine, Norwegian University of Science and Technology, N-7489 Trondheim, Norway
- Oslo University Hospital (NO)
- Norwegian University of Science and Technology (NO)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2007-03-01
- Volume
- 92
- Issue
- 3
- Pages
- 841-845
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2079601862
- Cited by
- 215
- References
- 29
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 8 · 2023: 7 · 2022: 13 · 2021: 9 · 2020: 15 · 2019: 15 · 2018: 17 · 2017: 8 · 2016: 13 · 2015: 12 · 2014: 15 · 2013: 11 · 2012: 18
- FWCI
- 7.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Norwegian Institute of Public Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- thyroid-stimulating hormone, blood pressure, hypertension, thyroid function, reference values, systolic blood pressure, diastolic blood pressure, pulse pressure, cardiovascular health
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Pressure, Cross-Sectional Studies, Female, Health Surveys, Humans, Hypertension, Male, Middle Aged, Norway, Reference Values, Thyrotropin
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