The relationship between subclinical thyroid dysfunction and blood pressure has been controversial and received unsufficient attention. Thus, we performed a cross-sectional study conducted among 6,992 inhabitants from six districts of Jiangsu Province to investigate the association of subclinical thyroid dysfunction with blood pressure in China. The data from 6,583 subjects (4,115 women and 2,468 men) were included and divided into three groups: euthyroidism (n = 5669, 86.11%), subclinical hyperthyroidism (n = 108, 1.65%), and subclinical hypothyroidism (n = 806, 12.24%). In the groups with subclinical hypothyroidism and hyperthyroidism, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure were not significantly different from those in the groups with euthyroidism after being adjusted for age, sex, BMI, and smoking status (P > 0.05). More extensively, the SBP and DBP in the group of subclinical hypothyroidism with lower level of TSH (TSH 4.51–10.00 mIU/l, SCH1) were significantly higher than those of participants with euthyroidism (P < 0.05). Multivariable logistic analysis revealed that subclinical hypothyroidism with lower TSH (TSH 4.51–10.00 mIU/l) was an independent risk factor for increased SBP (OR = 1.28, 95% CI 1.03–1.59, P = 0.028). Similar results could not be found between groups of euthyroid and subclinical hypothyroid with higher level of TSH (TSH > 10 mIU/l, SCH2). Further subdivision of the euthyroid group on the basis of a TSH cut-off of 2.5 mIU/l, revealed still no significant difference in blood pressure after adjustment regardless of whether the TSH levels were in the lower reference (TSH 0.40–2.50 mIU/l, n = 4093) or in the upper reference ranges (TSH 2.51–4.50 mIU/l, n = 1576) (P > 0.05). We concluded that subclinical thyroid dysfunction was not associated with blood pressure. Neither subclinical hyperthyroidism nor subclinical hypothyroidism independently predicted increased blood pressure.
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This work was supported by Medical Key Subject grants (SK200214, BS2004039) from Jiangsu Province, China. Chao Liu was supported by grants (RC2002047, LJ200619) from Jiangsu Province, China. We are grateful to all the participants and medical staff in the study.
G.W. Ching, J.A. Franklyn, T.J. Stallard, J. Daykin, M.C. Sheppard, M.D. Gammage, Cardiac hypertrophy as a result of long-term thyroxin therapy and thyrotoxicosis. Heart 75, 363–368 (1996)CrossRefPubMedGoogle Scholar
I. Saito, K. Ito, T. Saruta, Hypothyroidism as a cause of hypertension. Hypertension 5, 112–115 (1983)PubMedGoogle Scholar
D.H. Streeten, G.H. Anderson Jr, T. Howland, R. Chiang, H. Smulyan, Effects of thyroid function on blood pressure. Recognition of hypothyroid hypertension. Hypertension 11, 78–83 (1988)PubMedGoogle Scholar
H. Völzke, D. Alte, M. Dörr, H. Wallaschofski, U. John, S.B. Felix, R. Rettig, The association between subclinical hyperthyroidism and blood pressure in a population-based study. J. Hypertens. 24, 1947–1953 (2006)CrossRefPubMedGoogle Scholar
M. Dörr, B. Wolff, D.M. Robinson, U. John, J. Lüdemann, W. Meng, S.B. Felix, H. Völzke, The association of thyroid function with cardiac mass and left ventricular hypertrophy. J. Clin. Endocrinol. Metab. 90, 673–677 (2005)CrossRefPubMedGoogle Scholar
J.P. Walsh, A.P. Bremner, M.K. Bulsara, P. O’Leary, P.J. Leedman, P. Feddema, V. Michelangeli, Subclinical thyroid dysfunction and blood pressure: a community-based study. Clin. Endocrinol. 65, 486–491 (2006)CrossRefGoogle Scholar
J.P. Walsh, A.P. Bremner, M.K. Bulsara, P. O’Leary, P.J. Leedman, P. Feddema, V. Michelangeli, Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch. Intern. Med. 165, 2467–2472 (2005)CrossRefPubMedGoogle Scholar
B. Biondi, E.A. Palmieri, S. Fazio, C. Cosco, M. Nocera, L. Sacca, S. Filetti, G. Lombardi, F. Perticone, Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J. Clin. Endocrinol. Metab. 85, 4701–4705 (2000)CrossRefPubMedGoogle Scholar
M. Petretta, D. Bonaduce, L. Spinelli, M.S. Vicario, V. Nuzzo, F. Marciano, P. Camuso, V. De Sanctis, G. Lupoli, Cardiovascular haemodynamics and cardiac autonomic control in patients with subclinical and overt hyperthyroidism. Eur. J. Endocrinol. 145, 691–696 (2001)CrossRefPubMedGoogle Scholar
R.D. Lindeman, D.S. Schade, A. LaRue, L.J. Romero, H.C. Liang, R.N. Baumgartner, K.M. Koehler, P.J. Gary, Subclinical hypothyroidism in a biethnic, urban community. J. Am. Geriatr. Soc. 47, 703–709 (1999)PubMedGoogle Scholar
J. Kvetny, P.E. Heldgaard, E.M. Bladbjerg, J. Gram, Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin. Endocrinol. 61, 232–238 (2004)CrossRefGoogle Scholar
A.E. Hak, H.A. Pols, T.J. Visser, H.A. Drexhage, A. Hofman, J.C. Witteman, Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the rotterdam study. Ann. Intern. Med. 132, 270–278 (2000)PubMedGoogle Scholar
R. Luboshitzky, A. Aviv, P. Herer, L. Lavie, Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 12, 421–425 (2002)CrossRefPubMedGoogle Scholar
T. Nagasaki, M. Inaba, Y. Kumeda, Y. Hiura, K. Shirakawa, S. Yamada, Y. Henmi, E. Ishimura, Y. Nishizawa, Increased pulse wave velocity in subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 91, 154–158 (2006)CrossRefPubMedGoogle Scholar
O. Gumieniak, T.S. Perlstein, P.N. Hopkins, N.G. Brown, L.J. Murphey, X. Jeunemaitre, N.K. Hollenberg, G.H. Williams, Thyroid function and blood pressure homeostasis in euthyroid subjects. J. Clin. Endocrinol. Metab. 89, 3455–3461 (2004)CrossRefPubMedGoogle Scholar