Hyperthyroidism increases death, CVD risk
Adults with hyperthyroidism may be at increased risk for death and cardiovascular disease compared with those without hyperthyroidism, according to findings published in Thyroid.
Peter Giesecke, MD, of the department of clinical sciences at Danderyd Hospital and the Karolinska Institutet in Stockholm, and colleagues evaluated data from an observational register study between 1976 and 2012 on 12,239 adults with hyperthyroidism (Graves’ disease or toxic nodular goiter) treated with either radioactive iodine or surgery and compared them with 3,685 adults treated for nontoxic goiter. Researchers sought to determine whether improvements in CV care can change the prognosis over time, as well as the effect of different etiologies of hyperthyroidism. Follow-up was a median 18.4 years.
The hyperthyroidism group had increased all-cause mortality (HR = 1.27; 95% CI, 1.2-1.35) and CV mortality (HR = 1.29; 95% CI, 1.17-1.42) compared with the nontoxic goiter group. The risk for all-cause mortality was increased for Graves’ disease (HR = 1.14; 95% CI, 1.03-1.27) and toxic nodular goiter (HR = 1.42; 95% CI, 1.28-1.57) compared with the nontoxic goiter group.
Regardless of type of hyperthyroidism or duration of follow-up, the risk for death from ischemic heart disease or cerebrovascular disease was significantly increased.
Participants aged 46 to 58 years with toxic nodular goiter had the highest CV risk (HR = 1.25; 95% CI, 1.12-1.39), followed by participants aged 59 to 70 years (HR = 1.23; 95% CI, 1.11-1.36).
“This study indicates that the increased [CV] risk in hyperthyroid patients is related to the disease itself, rather than its treatment,” the researchers wrote. “Much of the excess mortality and morbidity is found among individuals treated for toxic nodular goiter. Despite breakthroughs in [CV] care during recent decades, hyperthyroidism is still a diagnosis associated with increased [CV] risk.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.