SpringerLink
Log in

Gender-specific associations between subclinical hypothyroidism and blood pressure in Chinese adults

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Hypothyroidism is often related with increased blood pressure, yet, gender-specific associations between subclinical hypothyroidism (SCH) and hypertension have not been previously assessed. We conducted a large-scale, cross-sectional study from six districts of Jiangsu Province to investigate the association of SCH and blood pressure in female and male adults. In the studied population, 4725 participants (3034 women and 1691 men) aged 20–60 years were included. The prevalence of hypertension was significantly higher in males as compared to females (37.34% vs. 27.39%, P < 0.05), while the prevalence of SCH was much higher in women (9.36% vs. 5.32%, P < 0.05). Furthermore, the hypertension rate was significantly higher in female SCH group compared to euthyroid (EUT) group(P < 0.05), while no significant differences were observed between the two groups in male participants(P > 0.05). After adjusting for age and body mass index (BMI), SCH was an independent predictor for increased SBP (OR = 1.47, 95%CI 1.08–1.99, P = 0.015) and elevated pulse pressure (OR = 1.45, 95%CI 1.05–1.99, P = 0.024) in females, and serum thyroid stimulating hormone (TSH) was significantly higher in female hypertensive group as compared to normotensive group (2.09 vs. 1.92 mIU/l, P = 0.0004). In male participants, SCH was not independently correlated with blood pressure, and no significant difference in TSH levels between hypertensive and normotensive groups was observed (1.74 vs. 1.66 mIU/l, P = 0.12). We concluded that SCH is an independent predictor of increased SBP and pulse pressure in females. Thus, thyroid function may influence blood pressure to a greater extent in females compared to males.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. G.J. Kahaly, W.H. Dillmann, Thyroid hormone action in the heart. Endocr. Rev. 26, 704–728 (2005)

    Article  CAS  PubMed  Google Scholar 

  2. R. Polikar, A.G. Burger, U. Scherrer, P. Nicod, Thyroid and the heart. Circulation 87, 1435–1441 (1993)

    CAS  PubMed  Google Scholar 

  3. S. Danzi, I. Klein, Thyroid hormone and blood pressure regulation. Cur. Hypertens. Rep. 5, 513–520 (2003)

    Article  Google Scholar 

  4. I. Saito, K. Ito, T. Saruta, Hypothyroidism as a cause of hypertension. Hypertension 5, 112–115 (1983)

    CAS  PubMed  Google Scholar 

  5. K. Hamano, M. Inoue, Increased risk for atherosclerosis estimated by pulse wave velocity in hypothyroidism and its reversal with appropriate thyroxine treatment. Endocr. J. 52, 95–101 (2005)

    Article  CAS  PubMed  Google Scholar 

  6. C. Meier, J.J. Staub, C.B. Roth, TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebocontrolled trial (basel thyroid study). J. Clin. Endocr. Metab. 86, 4860–4866 (2001)

    Article  CAS  PubMed  Google Scholar 

  7. D.H. Streeten, G.H. Anderson, T. Howland, R. Chiang, H. Smulyan, Effects of thyroid function on blood pressure. Recognition of hypothyroid hypertension. Hypertension 11, 78–83 (1988)

    CAS  PubMed  Google Scholar 

  8. A. Roos, S.L. Bakker, T.P. Links, R.B. Gans, B.R. Wolffenbuttel, Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J. Clin. Endocr. Metab. 92, 491–496 (2007)

    Article  CAS  PubMed  Google Scholar 

  9. M. Uzunlulu, E. Yorulmaz, A. Oguz, Prevalence of subclinical hypothyroidism in patients with metabolic syndrome. Endocr. J. 54, 71–76 (2007)

    Article  CAS  PubMed  Google Scholar 

  10. J.P. Walsh, S.P. Bremner, M.K. Bulsara, P. OLeary, P.J. Leedman, P. Feddema, V. Michelangeli, Thyroid dysfunction and serum lipids: a community-based study. Clin. Endocr. 63, 670–675 (2005)

    Article  CAS  PubMed  Google Scholar 

  11. R. Luboshitzky, A. Aviv, P. Herer, L. Lavie, Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 12, 421–425 (2002)

    Article  PubMed  Google Scholar 

  12. 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. Endocr. Metab. 91, 154–158 (2006)

    Article  CAS  PubMed  Google Scholar 

  13. 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. Endocr. Metab. 90, 673–677 (2005)

    Article  PubMed  Google Scholar 

  14. A.R. Cappola, L.P. Fried, A.M. Arnold, M.D. Danese, L.G. Kuller, G.L. Burke, R.P. Tracy, P.W. Ladenson, Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 295, 1033–1041 (2006)

    Article  CAS  PubMed  Google Scholar 

  15. J.G. Hollowell, N.W. Staehling, W.D. Flanders, W.H. Hannon, E.W. Gunter, C.A. Spencer, L.E. Braverman, Serum TSH, T4, and thyroid antibodies in the United States population (1988–1994): national health and nutrition examination survey (NHANES III). J. Clin. Endocr. Metab. 87, 489–499 (2002)

    Article  CAS  PubMed  Google Scholar 

  16. W.M.G. Tunbridge, D.C. Evered, R. Hall, D. Appleton, M. Brewis, F. Clark, J.G. Evans, E. Young, T. Bird, P.A. Smith, The spectrum of thyroid disease in a community: the Whickham Survey. Clin. Endocr. 7, 481–493 (1977)

    Article  CAS  PubMed  Google Scholar 

  17. A. Sayed, N. Ali, Y. Bo Abbas, E. Alfadhli, Subclinical hypothyroidism is associated with early insulin resistance in Kuwaiti women. Endocr. J. 53, 653–657 (2006)

    Article  PubMed  Google Scholar 

  18. N. Takashima, Y. Niwa, T. Mannami, H. Tomoike, N. Iwai, Characterization of subclinical thyroid dysfunction from cardiovascular and metabolic viewpoints: the suita study. Circ. J. 71, 191–195 (2007)

    Article  CAS  PubMed  Google Scholar 

  19. 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. Endocr. (Oxf) 61, 232–238 (2004)

    Article  CAS  Google Scholar 

  20. 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. Endocr. (Oxf) 65, 486–491 (2006)

    Article  CAS  Google Scholar 

  21. M. Pesic, S. Antic, R. Kocic, D. Radojkovic, S. Radenkovic, Cardiovascular risk factors in patients with subclinical hypothyroidism. Vojnosanit. Pregl. 64, 749–752 (2007)

    PubMed  Google Scholar 

  22. W.I. Khalife, Y.D. Tang, J.A. Kuzman, T.A. Thomas, B.E. Anderson, S. Said, P. Tille, E.H. Schlenker, A.M. Gerdes, Treatment of subclinical hypothyroidism reverses ischemia and prevents myocyte loss and progressive LV dysfunction in hamsters with dilated cardiomyopathy. Am. J. Physiol. Heart Circ. Physiol. 289, H2409–H2415 (2005)

    Article  CAS  PubMed  Google Scholar 

  23. M. Sowers, J. Luborsky, C. Perdue, K.L. Araujo, M.B. Goldman, S.D. Harlow, SWAN. Thyroid stimulating hormone (TSH) concentrations and menopausal status in women at the mid-life: SWAN. Clin. Endocr. (Oxf) 58, 340–347 (2003)

    Article  CAS  Google Scholar 

  24. D. Perloff, C. Grim, J. Flack, Human blood pressure determination by sphygmomanometry. Circulation 88, 2460–2470 (1993)

    CAS  PubMed  Google Scholar 

  25. Z. Baloch, P. Carayon, B. Devolx, Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 13, 123–126 (2003)

    Google Scholar 

Download references

Acknowledgments

This study was supported by a Medical Key Subject grant from Jiangsu Province, China. Chao Liu was supported by grants, RC2002047and LJ200619, from Jiangsu Province, China. We are grateful to all the patients and medical staff who participated in the study.

Author information

Authors and Affiliations

  1. Department of Endocrinology, First Affiliated Hospital, Nan**g Medical University, 210029, Nan**g, China

    Yu Duan, ** Liu & Chao Liu

  2. Department of Endocrinology, Wuxi First Hospital, 214002, Wuxi, China

    Ruifang Bo

  3. Department of Endocrinology, First Affiliated Hospital, Xuzhou Medical College, 221002, Xuzhou, China

    Wei Li

  4. Department of Endocrinology, Jiangbin Hospital, Jiangsu University, 212001, Zhenjiang, China

    Junjian Chen

Authors
  1. Yu Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. **aodong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wen Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yu Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wei Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. **aohong Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. **aodong Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ruifang Bo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Junjian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Youwen Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Cui** Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Chao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chao Liu.

Additional information

Y. Duan, X. Wang—contributed equally to this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duan, Y., Wang, X., Peng, W. et al. Gender-specific associations between subclinical hypothyroidism and blood pressure in Chinese adults. Endocr 36, 438–444 (2009). https://doi.org/10.1007/s12020-009-9244-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-009-9244-5

Keywords

Search

Navigation