Völzke Henry, Alte Dietrich, Dörr Marcus, Wallaschofski Henri, John Ulrich, Felix Stephan B, Rettig Rainer
Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Walther Rathenau Str. 48, D-17487 Greifswald, Germany.
J Hypertens. 2006 Oct;24(10):1947-53. doi: 10.1097/01.hjh.0000244942.57417.8e.
Although evidence for an increased risk of hypertension in both overt hyperthyroidism and overt hypothyroidism is consistent, the relation between subclinical hyperthyroidism and blood pressure has not yet received sufficient attention.
The Study of Health in Pomerania is a population-based survey in Germany that was conducted in a previously iodine-deficient region. A study population of 4087 subjects (2050 women) without overt hyperthyroidism or increased serum thyrotropin levels was available for the present study. Serum thyrotropin levels < 0.25 mIU/l and < 0.1 mIU/l were considered decreased and suppressed, respectively.
Multivariable analyses revealed lower adjusted mean values for systolic blood pressure in subjects with decreased [132.9 mmHg, 95% confidence interval (CI) = 131.1 mmHg; 134.8 mmHg] versus normal serum thyrotropin levels (135.0 mmHg, 95% CI = 134.4 mmHg; 135.6 mmHg, P = 0.04). The adjusted mean values for diastolic blood pressure and pulse pressure did not differ significantly between both groups. Analyses that were performed after all subjects receiving antihypertensive medications had been excluded did not reveal any statistically significant associations between decreased serum thyrotropin levels and the endpoints investigated. There was also no association of suppressed serum thyrotropin levels with blood pressure or hypertension.
It is concluded that subclinical hyperthyroidism, as demonstrated by decreased as well as suppressed serum thyrotropin levels and serum free thyroid hormone levels within the reference range, is not associated with hypertension.
尽管有证据表明，显性甲状腺功能亢进和显性甲状腺功能减退患者患高血压的风险均会增加，但亚临床甲状腺功能亢进与血压之间的关系尚未得到充分关注。
波美拉尼亚健康研究是在德国一个先前缺碘地区开展的一项基于人群的调查。本研究纳入了4087名无显性甲状腺功能亢进或血清促甲状腺激素水平升高的受试者（2050名女性）。血清促甲状腺激素水平<0.25 mIU/l和<0.1 mIU/l分别被视为降低和抑制。
多变量分析显示，血清促甲状腺激素水平降低的受试者（收缩压调整后平均值为132.9 mmHg，95%置信区间[CI]=131.1 mmHg；134.8 mmHg）与血清促甲状腺激素水平正常的受试者（收缩压调整后平均值为135.0 mmHg，95%CI=134.4 mmHg；135.6 mmHg，P=0.04）相比，收缩压调整后平均值较低。两组之间舒张压和脉压的调整后平均值无显著差异。在排除所有接受抗高血压药物治疗的受试者后进行的分析未发现血清促甲状腺激素水平降低与所研究终点之间存在任何统计学显著关联。血清促甲状腺激素水平抑制与血压或高血压之间也无关联。
结论是，如血清促甲状腺激素水平降低以及抑制，且血清游离甲状腺激素水平在参考范围内所表明的亚临床甲状腺功能亢进与高血压无关。
