P3259Early markers of atherosclerosis and cardiovascular risk in women with hypertension and hypothyroidism

Abstract

Purpose: To examine influence of subclinical hypothyroidism on early markers of atherosclerosis and cardiovascular risk in women with hypertension. Methods: Women (n=134), mean age 56.8±0.5 years) with hypertension were included into this study in dependence from thyroid function: 1st group (n=33) with subclinical hypothyroidism, 2nd group (n=32) with subclinical hypothyroidism receiving levothyroxin treatment, 3rd group (n=34) with overt hypothyroidism and 4th group (n=35) with euthyroidism. Measurements were made of body mass index, thyrostimulating hormone (TSH), free T4, lipids profile, carotid artery intimamedia thickness (IMT) and ankle-brachial index (ABI). Also SCORE scales for total cardiovascular risk estimation were used. Results: The plasma concentration of TSH was closely associated with cholesterol levels (r=0.59; P<0.01) and LDL-cholesterol (r=0.55; P<0.01). The IMT in the 1st group was more (0.98±0.04 mm, P<0.05) than in the 2nd (0.87±0.03 mm) and 4th (0.83±0.04 mm) groups. ABI in the 1st (1.05±0.11) and 4th (1.00±0.11) groups was significantly lower than in the 3rd (1.13±0.13, P<0.01) group. We found higher prevalence of high risk in women with subclinical hypothyroidism compared with the 4th group (euthyroidism) - 36.4 vs 11.4% by SCORE scale and we didn't find any patients with very high risk. After we reestimated risk including results of sonography examination carotid artery and low ankle-brachial index (ABI), we found increasing prevalence of high and very high risk in women with subclinical hypothyroidism from 36.4 to 75.7%. Conclusion: Our results showed that subclinical hypothyroidism just like overt hypothyroidism influences on early markers of atherosclerosis and cardiovascular risk in women with hypertension. Hypothyroidism has association with increased level of total cholesterol, LDL-cholesterol, IMT, decreased ABI. Women with hypertension, subclinical hypothyroidism and levothyroxin treatment have better lipids profile and lower cardiovascular risk compared with hypothyroid patients without levothyroxine replacement therapy.