Saito I, Saruta T
Health Center, Keio University, Tokyo, Japan.
Endocrinol Metab Clin North Am. 1994 Jun;23(2):379-86.
Hypertension is more common in hypothyroidic patients than in euthyroid controls in older age groups. Treatment of the thyroid deficiency alone lowers blood pressure in most patients. Hemodynamically, cardiac output is reduced and total peripheral resistance is elevated. The latter probably is secondary to an increase of sympathetic nervous tone and a relative increase in alpha-adrenergic response. In hyperthyroidism, elevation of diastolic blood pressure is uncommon. Systolic hypertension is more common in younger age groups. Treatment of the hyperthyroidism alone lowers systolic blood pressure in most patients. An increase in cardiac output and a decrease in total peripheral resistance accompany the hyperthyroidism. Potentiation of catecholamine action by an excess of thyroid hormone has been invoked as an explanation, because thyroid hormone excess is accompanied by increased beta-adrenergic receptors in some tissue, including heart.
在老年人群中，甲状腺功能减退患者比甲状腺功能正常的对照者更易患高血压。仅治疗甲状腺功能减退就能使大多数患者的血压降低。从血流动力学角度来看，心输出量降低，总外周阻力升高。后者可能继发于交感神经张力增加以及α-肾上腺素能反应相对增强。在甲状腺功能亢进症中，舒张压升高并不常见。收缩期高血压在较年轻人群中更为常见。仅治疗甲状腺功能亢进症就能使大多数患者的收缩压降低。甲状腺功能亢进症伴有心输出量增加和总外周阻力降低。有人认为甲状腺激素过多会增强儿茶酚胺的作用，因为甲状腺激素过多会使包括心脏在内的一些组织中的β-肾上腺素能受体增加。
