Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Large and medium sized artery abnormalities in untreated and treated hypothyroidism
,
*Cattedra Medicina Interna, Università di Milano and Ospedale S. Gerardo Monza
Centro Fisiologia Clinica e Ipertensione, Ospedale Maggiore di Milano Milano, Italy
Centro Auxologico Italiano Milano, Italy
revised 30 January 1997; accepted 24 February 1997.
Correspondence: Prof. Giuseppe Mancia, Chair Medicina Interna 1, Ospedale S. Gerardo Nuovo, V. Donizetti 106, Monza (MI), Italy
Abstract
BACKGROUND: Hypothyroidism is frequently accompanied by cardiac dysfunction, increased vascular resistance and a greater prevalence of hypertension. Whether this condition is also accompanied by alterations of large artery function and structure is not known, however.
PATIENTS AND METHODS: We investigated radial artery compliance and wall thickness as well as carotid artery compliance in 11 normotensive recently diagnosed and never treated hypothyroid patients. Fifteen euthyroid healthy age- and sex-matched subjects served as controls. No subject had evidence of large artery atherosclerotic lesions. Carotid artery diameter was evaluated continuously by a B-M mode device and carotid compliance obtained by the Reneman formula. Radial artery diameter and wall thickness were continuously acquired over the systodiastolic blood pressure range (beat-to-beat finger measurement) by an echo-tracking device, and compliance (Langewouters formula) was expressed as the integral of the area under the compliance/blood pressure curve normalized for pulse pressure.
RESULTS: Patients with hypothyroidism showed greater radial wall thickness (+109%, P<0·01) and compliance (+58%, P<0·03) than controls. Carotid artery compliance was not different in the two groups. In 10 hypothyroid patients L- tiroxine therapy for 9·0±2·3 months did not change carotid artery function but markedly reduced radial artery wall thickness (–36%, P<0·05) and compliance (–20%, P<0·05).
CONCLUSIONS: Hypothyroidism is associated with early arterial structural and functional alterations, which involve more muscular than elastic arteries. These alterations, however, are reversible by hormonal replacement therapy.
Key Words: Hypothyroidism • cardiovascular system • thyroid hormones • arterial compliance
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