Thyroid disease and vascular risk

[helvella]

The end of this paper includes these two statements:

Analysis of more than 3,000 participants aged 65 years or more without heart failure at baseline, who were followed up for 12 years in the Cardiovascular Health Study, showed that SCH participants who were treated with levothyroxine had a 72% reduction in heart failure events.

AND

Despite known cardiovascular risks of SCH, there is not enough evidence for treating all patients at present due to current data being mostly based on observational studies or from small interventional trials with cardiac risk factor change as outcomes.

How many people have to suffer heart failure in order to provide the evidence that appropriate treatment of sub-clinical hypothyroidism is required?

Thyroid disease and vascular risk

Avais Jabbar, clinical research associate A and

Salman Razvi, consultant endocrinologist B⇑

+ Author Affiliations

A Newcastle University, Newcastle-upon-Tyne, UK

B Department of Endocrinology, Queen Elizabeth Hospital, Gateshead, UK, and honorary senior lecturer, Newcastle University, Newcastle-upon-Tyne, UK

ABSTRACT

Subclinical hypothyroidism (SCH) is a common condition seen in up to 10% of adults, mainly women and the elderly. Several prospective longitudinal cohort studies have shown a higher risk of cardiovascular disease in people with SCH but mainly in younger individuals. There are also a number of interventional trials that have shown that treatment of SCH with levo-thyroxine improves cardiovascular risk factors, but there is a dearth of level 1 evidence regarding cardiovascular events. In addition, there is increasing proof concerning the association of abnormal thyroid function at the time of an acute myocardial infarction with adverse cardiovascular outcomes. This review describes the literature dealing with thyroid function in relation to cardiovascular disease and also outlines the effect of treatment in addressing cardiovascular risk.

clinmed.rcpjournal.org/cont...

Rod

[PR4NOW]

Even when they do the science nobody wants to believe it. It always seems to come back to 'we need more studies'. They function about as effectively as the US Congress. PR

[LuckyKat]

Hi Helvella, thanks for posting this. I knew nothing of thyroid issues until I was diagnosed but then could see that Hashimoto's runs in both sides of my family - lots of symptoms but no diagnoses. My Dad died of a heart attack 2 years before I started to learn about the condition and had many health problems that I feel sure could have been successfully treated with thyroid hormone replacement. The part I find particularly annoying (when looking at it in a non-personal way) is that the NHS were prepared to fund a quadruple bypass op for my Dad several years before he died, but this knowledge of a link between thyroid problems and heart problems is known about and not acted upon. My Dad cost us all a fortune in treatments for all of his conditions and thyroid was never mentioned. Where is all the joined up thinking?

[helvella Administrator Thyroid UK]

So much evidence is not even noticed. So many things are dismissed on the basis that there is no evidence.

If the data were collected, there might be more evidence. But dismissing everything on the basis that "evidence that we have decided to call evidence" is all that matters is in every sense wrong. Ethically, morally, medically, financially, scientifically,...

Rod