HYPOTHYROIDISM INDUCED HYPERTENSION, AN OBSERVATIONAL STUDY

Kamlesh Taori, Seema Seth

Abstract


Introduction/ Background: In hypothyroidism, hypertension is not a usual sign but hypothyroidism is one of major
however often ignored cause of hypertension, which can be easily treated with thyroxine therapy most of the times. This
study was undertaken to find the relationship of thyroid function with blood pressure and compare the age-related increase in blood pressure in
euthyroid patients with that of hypothyroid patients and to assess the effect of thyroid hormone replacement therapy on blood pressure in
hypertensive hypothyroid patients.
Objective: To study the association between hypertension and hypothyroidism and to assess the response of adequate thyroid hormone
replacement therapy on blood pressure in hypothyroid hypertensive subjects.
Material and Method: Prospective observational study was undertaken in Rohilkhand Medical College and Hospital, Bareilly. This study
included 241 female patients aged 19-69years admitted in the medical wards from 1st Jan to 31st Dec 2018. Detailed clinical examination
including measurement of blood pressure and routine investigations including thyroid profile were done. The data was expressed as means ±
SEM and was statistically analyzed.
Results: On the basis of thyroid profile out of 241 cases, 87 were hypothyroid and 154 were euthyroid. Adiposity, age and sex related factor that
could influence blood pressure were excluded. Diastolic, rather than systolic blood pressure was significantly higher in hypothyroid patients
over 50 years than in euthyroid patients of corresponding age groups. 9 hypertensive hypothyroid patients who received adequate thyroid
replacement therapy for 6 ± 2 months had reduction in blood pressure . In rest of 5 patients who did not receive adequate thyroid replacement
therapy due to poor compliance, blood pressure and thyroid function tests remained unchanged.
Conclusion: In patients over 50years , we encountered hypertension more in hypothyroid patients than in euthyroid cases. Hypothyroid
patients had significantly higher diastolic blood pressure than euthyroid patients . Hypertension that was associated with hypothyroidism often
reduces in response to adequate thyroid hormone replacement therapy


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References


Endo T et al. Re-evaluation of a possible high incidence of hypertension in hypothyroid patients. Am Heart J 1979; 98: 684–688.

Saito I, Ito K, Saruta T. Hypothyroidism as a cause of Hypertension. Hypertension 1983; 5: 112–115.

Streeten DHP et al. Effects of thyroid function on blood pressure : recognition of hypothyroid hypertension. Hypertension 1988; 11: 78–83

Anderson GH Jr, Blakeman N, Streeten DHP. The effect of age on prevalence of secondary forms of hypertension in 4429 consecutively referred patients. J Hypertens s 1994; 12: 609–615.

Vanderpump MP et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol 1995; 43: 53– 68.

Chiang BN. Perlman LV. Epstein FH: Overweight and hypertension. A review. Circulation 39: 403, 1969.

Johnson AL, Cornoni JC. Cassel JC, Tyroler HA. Hayden S. Hames CG Influence of race, sex and weight on blood pressure behavior in young adults Am J Cardiol 35: 523. 1975.

Guyton AC: The relationship of cardiac output and arterial pressure control Circulation 64: 1079. 1981.

Coulombe P, Dussault JH. Walker P- Plasma catecholamine concentrations in hyperthyroidism and hypothyroidism Metabolism 25: 973. 1976.

Richards AM et al. Hypertension in hypothyroidism: arterial pressure and hormone relationships. Clin Exp Hypertens A 1985; 7: 1499–1514.

Fcek CM. Sawers JSA. Brown NS. Seth J. Irvine SW, Toft AD: Influence of thyroid status on dopaminergic inhibition of thyrotropin and prolactin secretion. Evidence for an additional feedback mechanism in the control of thyroid hormone secretion J Clin Endocrinol Metab 51: 585. 1980.

Snyder PJ, Jacobs LS. Utiger RD. Daughaday WH. Thyroid hormone inhibition of the prolactin response to thyrotropinrcleasing hormone. J Chn Invest 52: 2324, 1973.

Kolloch R. Kobayashi K, DeQuattro V Dopaminergic control of sympathetic tone and blood pressure Evidence in primary hypertension. Hypertension 2: 390, 1980.

Kohrle J, Brabant G, Hesch R-D. Metabolism of thyroid hormones. Horm Res 1987; 26: 58–78.

Williams RS, Lefkowitz RJ. Thyroid hormone regulation of a -adrenergic receptors: studies in the rat myocardium. J Cardiovasc Pharmacol 1979; 1: 181–189.

Bing RF et al. Reversible hypertension and hypothyroidism . Clin Endocrinol 1980; 13: 339–342.

Elias AN, Kyaw T, Valenta LJ, Meshkinpour H. The renin-angiotensin system in hypothyroidism of short duration. Horm Metab Res 1986; 18: 349–3513.

Hauger-Klevene JH, Brown H, Zavaleta J. Plasma rennin activity in hyper and hypothyroidism: effect of adre nergic blocking agents. J Clin Endocrinol Metab 1972; 34: 625–629.

Cole CH, Waddell RW. Alteration in intracellular sodium concentration and ouabain-sensitive ATPase in erythrocytes from hyperthyroid patients. J Clin Endocrinol Metab 1976; 42: 1056–1063.

Canessa M et al. Increased sodium-lithium countertransport in red cells of patients with essential hypertension. N Engl J Med 1980; 302: 772–776.

Kaplan MM. The role of thyroid hormone deiodination in the regulation of hypothalamo-pituitary function. Neuroendocrinology 1984; 38: 254–260.

Dratman MB, Goldman M, Crutchfield FL, Gordon TJ Nervous system role of iodocompounds in blood pressure regulation. Life Sci 1982; 30: 611–619.

Moses AM, Schieinman SJ. The kidneys and electrolyte metabolism in hypothyroidism. In: Braverman LE, Utiger RD (eds), Werner and Ingbar’s The Thyroid: a Fundamental and Clinical Text. 7th Edition. Philadelphia, 1996, pp 812–815.

Asvolt B O, Bjorn T, Nilsen T and Vatten L J The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 3, 1 March 2007, Pages 841–845


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