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Persistent subclinical hypothyroidism and cardiovascular risk in the elderly: the cardiovascular health study.
Monday,2013-01-14 16:58 America/Los_Angeles — poolea2
| Title | Persistent subclinical hypothyroidism and cardiovascular risk in the elderly: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2013 |
| Authors | Hyland, KA, Arnold, AM, Lee, JS, Cappola, AR |
| Journal | J Clin Endocrinol Metab |
| Volume | 98 |
| Issue | 2 |
| Pagination | 533-40 |
| Date Published | 2013 Feb |
| ISSN | 1945-7197 |
| Keywords | Aged, Aged, 80 and over, Coronary Disease, Female, Heart Failure, Humans, Hypothyroidism, Incidence, Longitudinal Studies, Male, Risk, Thyroid Function Tests |
| Abstract | <p><b>CONTEXT: </b>Use of a single set of thyroid function tests to define subclinical hypothyroidism may lead to misclassification over time and could influence findings from longitudinal studies.</p><p><b>OBJECTIVE: </b>We assessed the risks of coronary heart disease (CHD), heart failure (HF), and cardiovascular (CV) death in older adults with persistent subclinical hypothyroidism.</p><p><b>DESIGN, SETTING, AND PARTICIPANTS: </b>The study included 679 subclinically hypothyroid and 4184 euthyroid U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study and not taking thyroid preparations.</p><p><b>MAIN OUTCOME MEASURE: </b>We measured the 10-yr risk of incident CHD, HF, and CV death from persistent subclinical hypothyroidism, overall and stratified by degree of TSH elevation (4.5-6.9, 7.0-9.9, and 10.0-19.9 mU/liter).</p><p><b>RESULTS: </b>There was no association between persistent subclinical hypothyroidism and incident CHD [hazard ratio (HR), 1.12; 95% confidence interval (CI), 0.93-1.36], HF (HR, 1.05; 95% CI, 0.97-1.27), or CV death (HR, 1.07; 95% CI, 0.87-1.31) in adjusted analyses in which subclinical hypothyroidism was modeled as a time-varying exposure using up to four serial thyroid function tests. When subclinical hypothyroidism was stratified by degree of TSH elevation, no significant associations were found in any stratum. Findings were similar in fixed exposure analyses in which only participants with testing 2 yr apart were considered, with no association between persistent or transient subclinical hypothyroidism and incident CHD, HF, or CV death.</p><p><b>CONCLUSIONS: </b>Our data do not support increased risk of CHD, HF, or CV death in older adults with persistent subclinical hypothyroidism.</p> |
| DOI | 10.1210/jc.2012-2180 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 23162099 |
| PubMed Central ID | PMC3565111 |
| Grant List | R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R56 AG020098 / AG / NIA NIH HHS / United States R01AG-032317 / AG / NIA NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States R01 AG032317 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States |