Prevalence of cardiometabolic risk factors in patients with hypertension and subclinical hypothyroidism

Abstract

It is known that the presence of overt hypothyroidism carries additional risks of developing cardiovascular diseases due to impaired lipid and carbohydrate metabolism. But whether subclinical hypothyroidism (SH) has the same negative impact is still controversial. The assessment of its role is especially important in patients with existing arterial hypertension (AH) in the early stages of the disease in order to prevent future complications. The aim of this work is to identify and assess the prevalence of early cardiometabolic risk factors in patients with AH combined with SH. Materials and methods. 66 patients (55.4 % women) aged from 25 to 59 years with a median age of 51.1 years were included in the study during 2019–2020 years. All the patients were divided into 3 groups, randomized by age and sex: group 1 (n = 21) – vo­lunteers without AH and SH; group 2 (n = 25) – euthyroid patients with stage 1–2 grade 1–2 AH and low-to-moderate cardiovascular risk (CVR); group 3 (n = 20) – patients with stage 1–2 grade 1–2 AH and low-to-moderate CVR in combination with SH. Blood pressure was measured, anthropometric data were assessed, glucose levels and lipid profile indicators were determined in all patients. Results. Comparative characteristics of the groups showed a rise in the frequency of detecting increased waist circumference and the waist-to-hip ratio, obesity, metabolic syndrome, its individual components and lipid profile disorders, especially the levels of total cholesterol and high-density lipoprotein cholesterol in patients with SH even in the early stages of AH and CVR of low gradations. However, dyslipidemias in general and hypertriglyceridemia in particular were more common in euthyroid hypertensive patients compared to patients with AH and concomitant SH. There was also a tendency towards an increase in gynoid obesity and a worsening of the lipid and carbohydrate profile disorders in SH patients in comparison to euthyroid patients with AH, although the differences were not statistically significant. Conclusions. Evaluation of cardiometabolic risk factors revealed the increase in severity of female obesity and worsening of abnormalities in lipid and carbohydrate profiles with the SH development in patients even in the early stages of AH and low-CVR, that additionally increases the risk of cardiovascular complications.