Thyroid and Cardiovascular Risk

  • Wendy P. J. den ElzenEmail author
  • Simon P. Mooijaart
  • Bart E. P. B. Ballieux
  • Anne R. Cappola
  • Jacobijn Gussekloo


Here we present data on the clinical effects of abnormalities in thyroid hormone levels on cardiovascular risk, focusing on the risks associated with subclinical thyroid dysfunction. Some observational studies and randomized clinical trials have suggested that subclinical hypothyroidism causes reversible alterations in surrogate markers of cardiovascular disease such as lipid levels and carotid intima media thickness. RCTs and meta-analyses to date have not shown effects of levothyroxine treatment for patients with subclinical hypothyroidism on clinical and cardiovascular outcomes, but were underpowered to detect effects on cardiac events and mortality. Observational data strongly support the treatment of subclinical hyperthyroidism to prevent atrial fibrillation and heart failure, but the degree to which the cardiovascular risk is reversible is unknown since prospective, randomized controlled trials of treatment of subclinical hyperthyroidism are not available.


Lipids Total cholesterol LDL cholesterol Triglycerides HDL cholesterol ApoA ApoB C-reactive protein Homocysteine Hemostatic factors Arterial stiffness Carotid intima media thickness Endothelial dysfunction Epicardial fat tissue thickness Coronary artery calcification Ventricular function Blood pressure Metabolic syndrome Insulin resistance Diabetes Body composition Renal function Coronary heart disease Mortality Stroke Atrial fibrillation 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Wendy P. J. den Elzen
    • 1
    Email author
  • Simon P. Mooijaart
    • 2
    • 3
  • Bart E. P. B. Ballieux
    • 1
  • Anne R. Cappola
    • 4
  • Jacobijn Gussekloo
    • 2
    • 5
  1. 1.Department of Clinical Chemistry and Laboratory MedicineLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Section of Gerontology and Geriatrics, Department of Internal MedicineLeiden University Medical CenterLeidenThe Netherlands
  3. 3.The Institute for Evidence-based Medicine in Old AgeLeidenThe Netherlands
  4. 4.Division of Endocrinology, Diabetes, and Metabolism, Department of MedicineUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  5. 5.Department of Public Health and Primary CareLeiden University Medical CenterLeidenThe Netherlands

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