Streeten D H, Anderson G H, Howland T, Chiang R, Smulyan H
Department of Medicine, SUNY-Health Science Center, Syracuse 13210.
Hypertension. 1988 Jan;11(1):78-83. doi: 10.1161/01.hyp.11.1.78.
Hypothyroidism has been known to be associated, at times, with diastolic hypertension. We have found in 40 thyrotoxic patients that the induction of hypothyroidism by radioiodine therapy significantly increased diastolic blood pressure, raising it above 90 mm Hg in 16 (40%) of the patients. Restoration of euthyroidism with thyroxine administration significantly reduced the systolic and diastolic blood pressures in these patients, with a fall in diastolic pressure below 90 mm Hg in nine of 16 patients. The prevalence of hypothyroidism was determined by measurements of serum thyroxine and thyrotropin concentrations in 688 consecutive hypertensive patients, referred for evaluation and therapy of their hypertension. Hypothyroidism was found in 25 (3.6%) of the patients. Restoration of normal serum thyroxine and thyrotropin levels with thyroid hormone replacement therapy lowered diastolic blood pressure to levels below 90 mm Hg in 32% of these patients who could be followed up after withdrawal of all antihypertensive drug therapy when euthyroidism had been restored (i.e., 1.2% of the 688 patients). It is concluded that diastolic hypertension resulting from hypothyroidism is a relatively common disorder, present in 1.2% of our referred hypertensive patients, that should be sought and treated.
甲状腺功能减退有时被认为与舒张期高血压有关。我们在40例甲状腺毒症患者中发现，放射性碘治疗诱导甲状腺功能减退会显著升高舒张压，16例（40%）患者的舒张压升至90 mmHg以上。给予甲状腺素使甲状腺功能恢复正常后，这些患者的收缩压和舒张压显著降低，16例患者中有9例舒张压降至90 mmHg以下。对688例因高血压前来评估和治疗的连续高血压患者，通过检测血清甲状腺素和促甲状腺素浓度来确定甲状腺功能减退的患病率。在25例（3.6%）患者中发现了甲状腺功能减退。在停用所有抗高血压药物治疗且甲状腺功能恢复正常后，对这些患者进行随访，甲状腺激素替代治疗使血清甲状腺素和促甲状腺素水平恢复正常，32%的患者舒张压降至90 mmHg以下（即688例患者中的1.2%）。结论是，甲状腺功能减退导致的舒张期高血压是一种相对常见的疾病，在我们转诊的高血压患者中占1.2%，应予以查找和治疗。
