Subclinical Hypothyroidism—Just a High Serum Thyrotropin (TSH) Concentration or Something Else?

摘要

With advances in our understanding of the cellular mechanisms of thyroid hormone on both the heart and vas- cular smooth muscle cells, it has become increasingly clear why many of the most characteristic signs of thyroid dys- function are changes in blood pressure, heart rate, systemic vascular resistance, and cardiac contractility. Treatment par- adigms for patients with both overt thyrotoxicosis and hy- pothyroidism often use cardiovascular endpoints as well as standard thyroid function testing to assess the response to treatment (2, 3). In essentially every instance, the restoration of the euthyroid state also returns cardiovascular hemody- namics and cholesterol metabolism to normal.