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甲状腺疾病中的高血压

Hypertension in Thyroid Disorders.

作者信息

Berta Eszter, Lengyel Inez, Halmi Sándor, Zrínyi Miklós, Erdei Annamária, Harangi Mariann, Páll Dénes, Nagy Endre V, Bodor Miklós

机构信息

Department of Endocrinology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

Department of Clinical Pharmacology, University of Debrecen, Debrecen, Hungary.

出版信息

Front Endocrinol (Lausanne). 2019 Jul 17;10:482. doi: 10.3389/fendo.2019.00482. eCollection 2019.

Abstract

Arterial hypertension represents a major global health concern; more than one fourth of the population is affected by high blood pressure. Albeit the underlying cause of the disease remains unclear in the vast majority of the cases, ~10% are of secondary origin. Endocrine disorders are common illnesses and some of them may lead to elevated blood pressure, among which thyroid diseases are of high prevalence and often overlooked, especially in mild cases. Overt and subclinical hyper- and hypothyroidism can both lead to (mostly mild) hypertension; however, the underlying mechanisms are only partially understood. The results of clinical studies are often controversial. During the past decades, some genetic mutations in the hypothalamus-pituitary-thyroid axis with cardiovascular consequences were revealed. Atherosclerotic changes resulting from lipid abnormalities due to thyroid dysfunction also affect the vasculature and can cause elevated blood pressure. The review gives a synopsis of our knowledge how thyroid hormone metabolism and functional thyroid diseases affect the cardiovascular system, their negative impact and causative role in the development of hypertension.

摘要

动脉高血压是全球主要的健康问题;超过四分之一的人口受到高血压影响。尽管在绝大多数情况下该疾病的潜在病因仍不清楚,但约10%为继发性病因。内分泌失调是常见疾病,其中一些可能导致血压升高,甲状腺疾病患病率高且常被忽视,尤其是在轻症病例中。显性和亚临床甲状腺功能亢进及减退都可导致(大多为轻度)高血压;然而,其潜在机制仅部分为人所知。临床研究结果往往存在争议。在过去几十年中,发现了下丘脑 - 垂体 - 甲状腺轴的一些具有心血管后果的基因突变。甲状腺功能障碍导致的脂质异常引起的动脉粥样硬化变化也会影响血管系统并可导致血压升高。本综述概述了我们关于甲状腺激素代谢和功能性甲状腺疾病如何影响心血管系统、它们在高血压发生发展中的负面影响和致病作用的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6652798/4fbf99ae44cc/fendo-10-00482-g0001.jpg

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