Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism

Arq Bras Cardiol. 2010 Jun;94(6):806-12. doi: 10.1590/s0066-782x2010005000040. Epub 2010 Apr 30.
[Article in English, Portuguese]

Abstract

Background: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH) with arterial blood pressure (ABP) alteration is unknown.

Objective: The aim of the present study was to evaluate ambulatory blood pressure monitoring (ABPM), over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU) normotensive individuals.

Methods: A cross-sectional study was performed with 50 participants (SH = 30 and EU = 20) that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation) and by the BHS (British Hypertension Society).

Results: The mean serum TSH and FT4 were respectively 6.9 +/- 2.2 microUI/ml and 1.1 +/- 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP) and serum TSH levels in SH patients (r:0.477; p = 0.004). These correlations were detected at daytime (r:0.498; p = 0.002) and sleep-time (r:0.322; p = 0.032) measurements.

Conclusion: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

MeSH terms

  • Adult
  • Analysis of Variance
  • Blood Pressure Monitoring, Ambulatory*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / etiology
  • Hypertension / physiopathology*
  • Hypothyroidism / complications
  • Hypothyroidism / physiopathology*
  • Male
  • Middle Aged
  • ROC Curve
  • Reference Values
  • Risk Factors
  • Statistics, Nonparametric
  • Thyrotropin / blood
  • Thyroxine / blood
  • Time Factors

Substances

  • Thyrotropin
  • Thyroxine