Skip to main content
SpringerLink
Log in

Relationship Between Subclinical Thyroid Dysfunction and Heart Failure and Mortality

  • Chapter
Thyroid and Heart Failure

  • 963 Accesses

Abstract

This chapter reviews the data on subclinical thyroid dysfunction and heart failure and mortality. Observational studies have suggested that subclinical hypothyroidism is associated with a moderately elevated risk of heart failure events among older adults with a thyrotropin level higher than 7–10 mU/L. Such data are lacking for middle-aged adults. Subclinical thyroid dysfunction might also represent a potentially modifiable risk factor for mortality. In a recent systematic review and meta-analysis of prospective cohorts, adults less than 65 years of age with subclinical hypothyroidism were found to be at increased risk of all-cause and cardiovascular mortality. The situation might be reversed in the elderly. Data are more limited for subclinical hyperthyroidism. Large, randomized clinical trials are needed to assess the efficacy of thyroxine replacement or antithyroid medications on clinical outcomes such as cardiovascular disease (coronary heart disease, heart failure, cardiovascular mortality) in adults with subclinical thyroid dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Helfand M (2004) Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 140:128–141

    PubMed  Google Scholar 

  2. Surks MI, Ortiz E, Daniels GH et al (2004) Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 291:228–238

    Article  PubMed  CAS  Google Scholar 

  3. Haugen B (2003) When isn’t the TSH normal and why? Clinical implications and causes. Paper presented at the 12th Annual Meeting of the American Association of Clinical Endocrinologists (AACE), 14–18 May 2003, San Diego, California

    Google Scholar 

  4. Lee S (2003) When is the TSH normal? New criteria for diagnosis and management. Paper presented at the 12th Annual Meeting of the American Association of Clinical Endocrinologists (AACE), 14–18 May 2003, San Diego, California

    Google Scholar 

  5. Hollowell JG, Staehling NW, Flanders WD et al (2002) Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87:489–499

    Article  PubMed  CAS  Google Scholar 

  6. Parle JV, Franklyn JA, Cross KW et al (1991) Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol (Oxf) 34:77–83

    Article  CAS  Google Scholar 

  7. Sawin CT, Castelli WP, Hershman JM et al (1985) The aging thyroid. Thyroid deficiency in the Framingham Study. Arch Intern Med 145:1386–1388

    Article  PubMed  CAS  Google Scholar 

  8. Cooper DS (2001) Clinical practice. Subclinical hypothyroidism. N Engl J Med 345:260–265

    Article  PubMed  CAS  Google Scholar 

  9. Ladenson PW, Singer PA, Ain KB et al (2000) American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med 160:1573–1575

    Article  PubMed  CAS  Google Scholar 

  10. Villar H, Saconato H, Valente O, Atallah A (2007) Thyroid hormone replacement for subclinical hypothyroidism. Cochrane Database Syst Rev (3): CD003419

    Google Scholar 

  11. Gottdiener JS, Arnold AM, Aurigemma GP et al (2000) Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study. J Am Coll Cardiol 35:1628–1637

    Article  PubMed  CAS  Google Scholar 

  12. Biondi B, Palmieri EA, Lombardi G, Fazio S (2002) Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med 137:904–914

    PubMed  Google Scholar 

  13. Rodondi N, Newman AB, Vittinghoff E et al (2005) Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch Intern Med 165:2460–2466

    Article  PubMed  Google Scholar 

  14. Rodondi N, Bauer D, Cappola A et al (2008) Subclinical thyroid dysfunction, cardiac function and the risk of heart failure: The Cardiovascular Health Study. J Am Coll Cardiol 52:1152–1159

    Article  PubMed  CAS  Google Scholar 

  15. Manowitz NR, Mayor GH, Klepper MJ, DeGroot LJ (1996) Subclinical hypothyroidism and euthyroid sick syndrome in patients with moderate-to-severe congestive heart failure. Am J Ther 3:797–801

    Article  PubMed  Google Scholar 

  16. Fruhwald FM, Ramschak-Schwarzer S, Pichler B et al (1997) Subclinical thyroid disorders in patients with dilated cardiomyopathy. Cardiology 88:156–159

    Article  PubMed  CAS  Google Scholar 

  17. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado Thyroid Disease Prevalence Study. Arch Intern Med 160:526–534

    Article  PubMed  CAS  Google Scholar 

  18. Kanaya AM, Harris F, Volpato S et al (2002) Association between thyroid dysfunction and total cholesterol level in an older biracial population: The Health. Aging and Body Composition Study. Arch Intern Med 162:773–779

    Article  PubMed  Google Scholar 

  19. Althaus BU, Staub JJ, Ryff-De Leche A et al (1988) LDL/HDL-changes in subclinical hypothyroidism: possible risk factors for coronary heart disease. Clin Endocrinol (Oxf) 28:157–163

    Article  CAS  Google Scholar 

  20. Hak AE, Pols HA, Visser TJ et al (2000) Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 132:270–278

    PubMed  CAS  Google Scholar 

  21. Monzani F, Caraccio N, Kozakowa M et al (2004) Effect of levothyroxine replacement on lipid profile and intimamedia thickness in subclinical hypothyroidism: a double-blind, placebo-controlled study. J Clin Endocrinol Metab 89:2099–2106

    Article  PubMed  CAS  Google Scholar 

  22. Cappola AR, Fried LP, Arnold AM et al (2006) Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 295:1033–1041

    Article  PubMed  CAS  Google Scholar 

  23. Parle JV, Maisonneuve P, Sheppard MC et al (2001) Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study. Lancet 358:861–865

    Article  PubMed  CAS  Google Scholar 

  24. Walsh JP, Bremner AP, Bulsara MK et al (2005) Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med 165:2467–2472

    Article  PubMed  Google Scholar 

  25. Ochs N, Auer R, Bauer DC et al (2008) Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med 148:832–845

    PubMed  Google Scholar 

  26. Imaizumi M, Akahoshi M, Ichimaru S et al (2004) Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab 89:3365–3370

    Article  PubMed  CAS  Google Scholar 

  27. Gussekloo J, van Exel E, de Craen AJ et al (2004) Thyroid status, disability and cognitive function, and survival in old age. JAMA 292:2591–2599

    Article  PubMed  CAS  Google Scholar 

  28. Cooper DS (2004) Thyroid disease in the oldest old: the exception to the rule. JAMA 292:2651–2654

    Article  PubMed  CAS  Google Scholar 

  29. Aho K, Gordin A, Palosuo T et al (1984) Thyroid autoimmunity and cardiovascular diseases. Eur Heart J 5:43–46

    PubMed  CAS  Google Scholar 

  30. Bauer DC, Rodondi N, Stone KL, Hillier TA (2007) Thyroid hormone use, hyperthyroidism and mortality in older women. Am J Med 120:343–349

    Article  PubMed  CAS  Google Scholar 

  31. Åsvold BO, Bjøro T, Nilsen TIL et al (2008) Thyrotropin levels and risk of fatal coronary heart disease: The HUNT Study. Arch Intern Med 168:855–860

    Article  PubMed  Google Scholar 

  32. Auer R, Rodondi N (2008) Thyrotropin levels and coronary heart disease mortality [letter]. Arch Intern Med 168:2498–2499; author reply 2499

    Article  PubMed  Google Scholar 

  33. Ladenson PW (2008) Cardiovascular consequences of subclinical thyroid dysfunction: more smoke but no fire. Ann Intern Med 148:880–881

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland

    Reto Auer MD & Nicolas Rodondi MD, MAS

Authors
  1. Reto Auer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicolas Rodondi MD, MAS
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. C.N.R. Clinical Physiology Institute, S. Cataldo Research Campus, Pisa, Italy

    Giorgio Iervasi  & Alessandro Pingitore  & 

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Italia

About this chapter

Cite this chapter

Auer, R., Rodondi, N. (2009). Relationship Between Subclinical Thyroid Dysfunction and Heart Failure and Mortality. In: Iervasi, G., Pingitore, A. (eds) Thyroid and Heart Failure. Springer, Milano. https://doi.org/10.1007/978-88-470-1143-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1143-4_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1142-7

  • Online ISBN: 978-88-470-1143-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation