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Subclinical hypothyroidism tied to increased CVD risk and all-cause mortality

A recent meta-analysis, published in the journal Thyroid, suggests that subclinical hypothyroidism (SCH) could have an association with elevated cardiovascular disease (CVD) risk and all-cause mortality, especially among those already with a high CVD risk.

Researchers performed a meta-analysis of 35 studies (n=555,530), identified through a literature search on the PubMed and Embase databases.

Overall, SCH was found to have a modest association with CVD (relative risk [RR], 1.33; 95% CI, 1.14-1.54) and all-cause mortality (RR, 1.20; 95% CI, 1.07-1.34) and the association only held true for individuals aged <65 years. In a subgroup analysis by status of CVD risks, SCH was associated with a substantially increased risk for CVD (RR, 2.20; 95% CI, 1.28-3.77) and all-cause mortality (RR, 1.66; 95% CI, 1.41-1.94) in individuals with a high CVD risk. In individuals with low CVD risk, the association between SCH and CVD remained modest while the association between SCH and all-cause mortality remained insignificant.

The current American guidelines suggest treatment for SCH in individuals with thyroid-stimulating hormone levels ≥10 mIU/L; symptoms suggestive of hypothyroidism; a positive test for antibodies to thyroid peroxidase or evidence of atherosclerotic CVD, heart failure or CVD risk factors. According to the authors, the study findings could provide a new perspective in identifying a subgroup of individuals with SCH based on CVD risk that could benefit from treatment, and can subsequently contribute crucial evidence to support the current guidelines.


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