Fortini A, Cappelletti C, Leopardi A, Laureano R
Routine determination of TSH for the detection of hypo- and
hyperthyroidism in hypertensive women referring to a
specialized centre
11th Scientific Meeting, American Society of Hypertension
Am J Hypert
(Apr) 9:88A 1996
Both hypothyroidism and hyperthyroidism can cause hypertension.
Hypothyroidism is associated with
diastolic hypertension and elevated vascular resistance, possibly via
elevated sympathetic tone.
Hyperthyroidism is associated with systolic hypertension only and elevated
TPR, explained as an
increased sensitivity to catecholamines (see Endocrinol Metab Clin North
Am 1994:379-386).
We also know that in women, particularly, subclinical hypothyroidism, defined
as as elevation in TSH
levels, is rather common, occurring in 8% of women overall, and in 16% of
elderly women. In the
present abstract, Fortini et al looked at TSH levels obtained routinely in
156 women referred for
hypertension to a tertiary center.
TSH was increased in 15 patients (10%), with 6% subclinical and 4% overt
hypothyroidism. In only 5
of these, however, was thyroid replacement associated with reduction of the
blood pressure. Three
patients had hyperthyroidism, with reduction in BP with treatment in 2
patients.
Comment: Fortini et al suggest that TSH screening may be helpful in
hypertensive women,
although his data do not show a higher prevalence in this population than in
non-hypertensive women.
Also, it appears that in most of his hypothyroid patients, hypothyroidism was
contributing little
to the hypertensive state. (John T. Daugirdas, M.D., University of
Illinois at Chicago)
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11th Scientific Meeting, American Society of Hypertension
H: Special problems :
Endocrine hypertension