Vol 25, No 3 (2021)
Original paper
Published online: 2021-08-19

open access

Page views 11692
Article views/downloads 535
Get Citation

Connect on Social Media

Connect on Social Media

Factors affecting blood pressure in patients with arterial hypertension and subclinical hypothyroidism

Anastasiia O. Radchenko1, Olena V. Kolesnikova1
Arterial Hypertension 2021;25(3):127-134.

Abstract

Background: The aim our study was to identify factors affecting blood pressure in patients with hypertension (HTN) and subclinical hypothyroidism (SH).

Material and methods: One hundred and thirty-eight patients aged from 25 to 59 years were examined and divided into control group (n = 30), euthyroid patients with HTN (n = 45) and patients with HTN in combination with SH (n = 63). The levels of tumor necrosis factor-a, C-reactive protein, total hydroperoxide content, total antioxidant activity, total  uperoxide dismutase activity and sirtuin 1 were measured in addition to complete blood count and routine biochemical tests. The Kruskal-Wallis H test was used to test whether there was a significant difference between the independent and its dependent variables.

Results: Fewer factors affected systolic and diastolic blood pressure in patients with HTN and SH compared with euthyroid patients. These included age, waist circumference, insulin, triglycerides, very high-density lipoprotein cholesterol, and TAA. The opposite results were found in relation to the increase in pulse pressure: significant effects of gender, hemoglobin, alkaline phosphatase were observed in patients with SH and only the level of ACT had a significant influence in euthyroid patients.

Conclusions: Factors associated with blood pressure and their overall number differed among patients with SH and HTN compared with euthyroid patients with HTN. Such results may be due to changes in anthropometric parameters, metabolic profile and oxidative status in patients with concomitant SH.

Article available in PDF format

View PDF Download PDF file

References

  1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16(4): 223–237.
  2. Dyachuk DD, Moroz GZ, Gidzinskaya IM, et al. [Prevalence of risk factors for cardiovascular diseases in Ukraine: a modern view of the problem]. Ukrain J Cardiol. 2018; 1: 91–101.
  3. Zhou D, Xi Bo, Zhao M, et al. Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep. 2018; 8(1): 9418.
  4. GBD 2017 Risk Factor Collaborators, GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1345–1422.
  5. Dey A, Kanneganti V, Das D. A study of the cardiac risk factors emerging out of subclinical hypothyroidism. J Family Med Prim Care. 2019; 8(7): 2439–2444.
  6. Decandia F. Risk factors for cardiovascular disease in subclinical hypothyroidism. Ir J Med Sci. 2018; 187(1): 39–43.
  7. Iervasi G, Pingitore A, Gerdes AM, Razvi S. ed. Thyroid and Heart: A Comprehensive Translational Essay. Springer Nature, New York 2020.
  8. Kringeland E, Tell GS, Midtbø H, et al. Factors associated with increase in blood pressure and incident hypertension in early midlife: the Hordaland Health Study. Blood Press. 2020; 29(5): 267–275.
  9. Ferguson TS, Younger-Coleman NOM, Tulloch-Reid MK, et al. High-Sensitivity C-Reactive Protein is Related to Central Obesity and the Number of Metabolic Syndrome Components in Jamaican Young Adults. Front Cardiovasc Med. 2014; 1: 12.
  10. Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020; 75(6): 1334–1357.
  11. Pearce SHS, Brabant G, Duntas LH, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013; 2(4): 215–228.
  12. Szczepanek-Parulska E, Hernik A, Ruchała M. Anemia in thyroid diseases. Pol Arch Intern Med. 2017; 127(5): 352–360.
  13. Wopereis DM, Du Puy RS, van Heemst D, et al. Thyroid Studies Collaboration. The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data. J Clin Endocrinol Metab. 2018; 103(10): 3658–3667.
  14. Sengupta S, Jaseem T, Ambalavanan J, et al. Homeostatic Model Assessment-Insulin Resistance (HOMA-IR 2) in Mild Subclinical Hypothyroid Subjects. Indian J Clin Biochem. 2018; 33(2): 214–217.
  15. Chang YC, Hua SC, Chang CH, et al. High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker. J Clin Med. 2019; 8(6).
  16. Kim D, Vazquez-Montesino LM, Escober JA, et al. Low Thyroid Function in Nonalcoholic Fatty Liver Disease Is an Independent Predictor of All-Cause and Cardiovascular Mortality. Am J Gastroenterol. 2020; 115(9): 1496–1504.
  17. Kim D, Kim W, Joo SK, et al. Subclinical Hypothyroidism and Low-Normal Thyroid Function Are Associated With Nonalcoholic Steatohepatitis and Fibrosis. Clin Gastroenterol Hepatol. 2018; 16(1): 123–131.e1.
  18. Desideri G, Bocale R, D'Amore AM, et al. Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity. Intern Emerg Med. 2020; 15(1): 67–71.
  19. Patil VP, Shilpasree AS, Patil VS, et al. Evaluation of renal function in subclinical hypothyroidism. J Lab Physicians. 2018; 10(1): 50–55.
  20. Tuliani TA, Shenoy M, Belgrave K, et al. Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism. Am J Med Sci. 2017; 354(3): 285–290.
  21. Kolesnikova OV, Radchenko AO. [Modern view on the mechanisms of oxidative stress and its biomarkers in a larger number of non-communicable diseases]. Ukrain Therap J. 2020; 1: 51–61.
  22. Radchenko A, Kolesnikova O. Assessment of oxidative status and inflammation in patients with arterial hypertension and subclinical hypothyroidism and their relationship to aging rates. Ukrain Therap J. 2021(2).
  23. Shalimova A, Psarova V, Kochuieva M, et al. Features of hemodynamic and metabolic disorders in obese patients with resistant hypertension. Arterial Hypertension. 2020; 24(1): 22–29.
  24. Tellechea ML. Meta-analytic evidence for increased low-grade systemic inflammation and oxidative stress in hypothyroid patients. Can levothyroxine replacement therapy mitigate the burden? Endocrine. 2021; 72(1): 62–71.
  25. Zhang W, Huang Q, Zeng Z, et al. Sirt1 Inhibits Oxidative Stress in Vascular Endothelial Cells. Oxid Med Cell Longev. 2017; 2017: 7543973.
  26. Yamamoto M, Takahashi Y. The Essential Role of SIRT1 in Hypothalamic-Pituitary Axis. Front Endocrinol (Lausanne). 2018; 9: 605.
  27. Garg O, salam A, Singh S, et al. Correlation Between TSH and Body Mass Index in Male and Female Patients with Subclinical Hypothyroidism. Era's J Med Res. 2018; 5(2): 94–98.
  28. Mulic M, Muminovic S, Skrijelj F, et al. The importance of anthropometric parameters in patients with subclinical hypothyroidism. SANAMED. 2018; 13(1): 23.
  29. Tykarski A, Filipiak K, Januszewicz A, et al. 2019 Guidelines for the Management of Hypertension — Part 1–7. Arterial Hypertension. 2019; 23(2): 41–87.
  30. Prejbisz A, Dobrowolski P, Kosiński P, et al. Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians. Arterial Hypertension. 2019; 23(3): 117–182.
  31. Rahman S, Islam S, Haque T, et al. Association between serum liver enzymes and hypertension: a cross-sectional study in Bangladeshi adults. BMC Cardiovasc Disord. 2020; 20(1): 128.
  32. Tsuda K. Red blood cell abnormalities and hypertension. Hypertens Res. 2020; 43(1): 72–73.
  33. Chang CH, Yeh YC, Caffrey JL, et al. Metabolic syndrome is associated with an increased incidence of subclinical hypothyroidism - A Cohort Study. Sci Rep. 2017; 7(1): 6754.
  34. Guo W, Li X, Wu J, et al. Serum alkaline phosphatase is associated with arterial stiffness and 10-year cardiovascular disease risk in a Chinese population. Eur J Clin Invest. 2021; 51(8): e13560.
  35. Avolio AP, Kuznetsova T, Heyndrickx GR, et al. Arterial Flow, Pulse Pressure and Pulse Wave Velocity in Men and Women at Various Ages. Adv Exp Med Biol. 2018; 1065: 153–168.
  36. Yoon H, Lee JHo, Kim GS, et al. The relationship between anemia and pulse pressure and hypertension: The Korea National Health and Nutrition Examination Survey 2010-2012. Clin Exp Hypertens. 2018; 40(7): 650–655.
  37. Saladini F, Mos L, Fania C, et al. P5467Gender related differences in the clinical significance of elevated pulse pressure in the young. Results from the HARVEST study. Eur Heart J. 2019; 40(Suppl_1).
  38. Lee J, Ha J, Jo K, et al. Male-specific association between subclinical hypothyroidism and the risk of non-alcoholic fatty liver disease estimated by hepatic steatosis index: Korea National Health and Nutrition Examination Survey 2013 to 2015. Sci Rep. 2018; 8(1): 15145.
  39. Tsou MT. Subclinical Hypothyroidism Represents Visceral Adipose Indices, Especially in Women With Cardiovascular Risk. J Endocr Soc. 2021; 5(6): bvab028.
  40. Deng L, Wang L, Zheng X, et al. Women with Subclinical Hypothyroidism are at Higher Prevalence of Metabolic Syndrome and Its Components Compared to Men in an Older Chinese Population. Endocr Res. 2021 [Epub ahead of print]: 1–10.