MONDAY, April 23 (HealthDay News) -- New evidence suggests that
a type of overactive thyroid condition appears to boost the risk of
heart problems, especially atrial fibrillation (a form of irregular
heartbeat) and premature death.
Patients sometimes are reluctant to do anything about the
condition, known as subclinical hyperthyroidism, because it often
doesn't cause any symptoms. The findings show, however, that
"physicians and patients should take it seriously and consider the
appropriate way to treat it to prevent increases in heart disease,
bone problems and death," said Dr. Kenneth Burman, chief of the
endocrine section at Washington Hospital Center, in Washington,
D.C.
Patients with subclinical hyperthyroidism have too much of the
hormone created by the thyroid gland, which helps control people's
metabolism. An estimated 10 percent of the population has the
condition, which is considered to be less serious than overt
hyperthyroidism.
Researchers have wondered for years whether subclinical
hyperthyroidism puts people at risk of a variety of health
problems. Previous research has suggested it does, and a new study
takes a closer look and finds more reasons to suspect the condition
is dangerous.
The report authors examined the results of 10 studies, which
included nearly 53,000 participants. After adjusting their
statistics so they wouldn't be skewed by high or low numbers of
participants of certain ages or genders, the researchers found that
those with subclinical hyperthyroidism were 24 percent more likely
to die during the study periods, 29 percent more likely to die of
heart-related problems and 68 percent more likely to have atrial
fibrillation.
Burman, who wrote a commentary accompanying the study, said the
risk of early death and heart problems were still low even with the
increased risk. The risk of death during the study period, for
example, rose overall from 16 percent in those with normal thyroid
levels to 18 percent in those with subclinical hyperthyroidism. But
the heightened risk of atrial fibrillation was a significant jump,
he said. Atrial fibrillation causes the heart to fail to beat
properly, putting patients at higher risk of stroke.
What to do? Physicians often turn to medication first, then
surgery or treatment with radioactive iodine, Burman said. But
medication raises questions, he said: "Do you keep them on
medication indefinitely when they feel fine and the medications
have side effects?"
Study co-author Dr. Nicolas Rodondi, head of ambulatory care at
the University of Bern, in Switzerland, said treatment should be
considered if patients are in certain risk groups and only if their
thyroid levels remain abnormal after they're rechecked in three to
six months.
The next step in research is to confirm the analysis findings
and explore how treatment may help patients lower their risks of
problems, he said.
The study appears online April 23 in the journal
Archives of Internal Medicine. A second study, also published in the journal, examined whether the drug levothyroxine sodium -- a man-made form of the thyroid hormone -- would help reduce the risk of cardiovascular problems in patients with subclinical hypothyroidism.
The study of about 4,800 patients, led by researchers at
Newcastle University in England, found that the drug (brand names
include Synthroid), appeared to reduce the risk of heart problems
in relatively younger patients (aged 40 to 70) but not in older
patients (over 70).
In younger patients, about 4 percent of those treated with the
drug had heart disease, compared with nearly 7 percent of those who
weren't treated with it. After adjusting their statistics so they
wouldn't be skewed by various factors, the researchers found that
those who took the drug had a 39 percent lower risk of heart
disease.
The drug can, however, cause a variety of side effects.
Researchers could not definitively explain why older patients
didn't receive the same health benefit.
A co-author for this study has received a speaking fee from drug
manufacturer Merck Serono.
More information
For details about
thyroid diseases, try the U.S. National Library of Medicine.