O.I. Mitchenko, V.Yu. Romanov, M.V. GvozdykEarly markers of atherosclerosis in women with еssential hypertension, metabolic syndrome and subclinical hypothyroidism.

National Scientific Center “M.D. Strazhesko Institute of Cardiology NAMS of Ukraine”, Kyiv, Ukraine
The aim – to examine influence of subclinical hypothyroidism on early markers of atherosclerosis and cardiovascular risk in women with еssential hypertension and metabolic syndrome. Materials and methods. Women (n=134), mean age 56.8±0.5 years with еssential hypertension and metabolic syndrome were included into this study: 1st group (n=33) with subclinical hypothyroidism, 2nd group (n=32) with subclinical hypothyroidism receiving levothyroxin treatment, 3rd group (n=34) with overt hypothyroidism and 4th group (n=35) with euthyroidism. Measurements were made of body mass index, thyrostimulating hormone (TSH), free T4, lipids profile, carotid artery intima–media thickness (IMT) and ankle-brachial index (ABI). Also SCORE scales for total
cardiovascular risk estimation were used. Results. The plasma concentration of TSH was closely associated with cholesterol levels (r=0.59; P<0.01) and LDL-cholesterol (r=0.55; Р<0.01). The IMT in the 1st group was more (0.98±0.04 mm, P<0.05) than in the 2nd (0.87±0.03 mm) and 4th (0.83±0.04 mm) groups. ABI in the 1st (1.05±0.11) and 4th (1.00±0.11) groups was significantly lower than in the 3rd (1.13±0.13, P<0.01) group. We found higher prevalence of high risk in women with subclinical hypothyroidism compared with the 4th group (euthyroidism) – 36.4 vs 11.4 % by SCORE scale and we didn’t
find any patients with very high risk. After we reestimated risk including results of sonography examination carotid artery and low extremities (ABI), we found increasing prevalence of high and very high risk in women with subclinical hypothyroidism from 36.4 to 76.4 %. Conclusion. Our results showed that subclinical hypothyroidism influences cardiovascular risk in women with arterial hypertension. Hypothyroidism has association with increased level of total cholesterol, LDL-cholesterol, IMT, decreased ABI. Hypothyroid women with hypertension under levothyroxin treatment have better lipids profile and lower cardiovascular risk compared with hypothyroid patients without levothyroxine replacement therapy.

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