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13-07-2006 | Thyroid | Article

Elevated non-fatal vascular event risk in treated thyroid patients


Free abstract

UK scientists have found that individuals who have been treated for hyper- or hypothyroidism have no increased risk of mortality or serious vascular events, but they may have a greater risk for specific nonfatal vascular events.

Writing in the Journal of Clinical Endocrinology & Metabolism, the researchers commented that if this increased risk of non-fatal cardiovascular events remains despite successful treatment for thyroid disease, then "perhaps clinicians need to be more aggressive about investigating cardiovascular risk factors and disease in such patients."

They add: "Further research is required, but there may be a possible role for more widespread use of cardioprotective drugs such as aspirin, statins, and angiotensin-converting enzyme inhibitors in these patients."

These findings emerge from an assessment of the rate of all-cause and cardiovascular mortality in 15,889 primary hypothyroid and 3,888 primary hyperthyroid patients, all of whom had received treatment for their disorder and whose condition had stabilized. Their data was compared with that for 524,152 individuals from the general population.

Graham Leese and co-investigators, from Ninewells Hospital and Medical School in Dundee, found that patients who had received treatment for thyroid disease were at no increased risk of all-cause mortality or serious vascular events compared with the general population.

However, individuals who were treated for hypothyroidism suffered a higher rate of nonfatal ischemic heart disease and dysrhythmias compared to the general population, with standardized incidence ratios (SIRs) of 1.23 and 1.32, respectively.

Individuals who received therapy for hyperthyroidism showed an elevated risk of dysrhythmias compared to the general population, with an SIR of 2.71.

"We found no increase in all-cause mortality in subjects with treated thyroid disease," Leese et al summarize.

"However, there was an increased risk of cardiovascular morbidity in patients with treated primary hypothyroidism and dysrhythmias in treated hyperthyroidism," they add.