Hypothyroidism: high TSH levels tied to CVD, mortality

  • BMJ

  • International Clinical Digest
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Takeaway

  • In patients with hypothyroidism, high concentrations of thyroid-stimulating hormone (TSH) are associated with increased risk of cardiovascular disease (CVD) and fractures, while both high and low TSH concentrations are linked to increased mortality risk.

Why this matters

  • This study indicates that long-term health outcomes are not adversely affected by hypothyroidism as long as TSH levels are within the recommended normal range.

Key results

  • High TSH (>10 mIU/L) was associated with increased risk of ischaemic heart disease (HR, 1.18; P=.03), heart failure (HR, 1.42; P<.001 and fragility fractures p=".03)" compared with normal tsh miu>
  • Low TSH was associated with reduced risk of heart failure (HR, 0.79; P=.04 for
  • Mortality risk was increased in patients with low TSH (HR, 1.18; P<.001 for miu and in patients with high tsh p hr>10 mIU/L).

Study design

  • 162,369 patients with hypothyroidism (863,072 total TSH measurements) were analysed for TSH levels and associations with CVD, fractures, and mortality.
  • Funding: None.

Limitations

  • Retrospective study.