Dataset Information

Arterial Stiffness and Blood Pressure in Patients Newly Diagnosed with Graves' Disease Compared with Euthyroid Controls.

ABSTRACT: Introduction and Objective:The excess cardiovascular morbidity and mortality in hyperthyroidism and Graves' disease (GD) is inadequately understood. We aimed to elucidate whether well-established cardiovascular risk factors such as arterial stiffness in terms of pulse wave velocity (PWV) and blood pressure differ in GD and controls. Methods:This was a cross-sectional study comparing 55 hyperthyroid patients with newly diagnosed GD and 55 euthyroid, population-based controls matched for age, sex and menopausal status. PWV and blood pressure were measured in office (SphygmoCor Xcel) and 24-h ambulatory settings (Arteriograph). Differences between groups were assessed using adjusted linear regression analysis. Results:Compared to controls, GD patients showed higher PWV in the 24-h but not in the office setting with an adjusted 24-h PWV difference of 1.0 (95% CI: 0.6-1.5) m/s. PWV was higher in GD at both day and night, and nightly PWV dipping was lower (-5.5, 95% CI: -10.4 to -0.6%). Furthermore, central and brachial pulse pressure was significantly higher in both the office and 24-h setting, whereas nightly central pulse pressure dipping was significantly lower in GD (-5.4, 95% CI: -10.5 to -0.2%). Mean arterial pressure did not differ between the groups. Conclusions:Despite comparable blood pressure, GD is associated with a higher 24-h PWV that was not detected in the office setting. Pulse pressure was higher in GD, whereas mean arterial pressure did not differ between the groups. Longitudinal studies should pursue whether higher PWV might be a piece to the puzzle of understanding the increased risk of cardiovascular disease in hyperthyroidism and GD.

SUBMITTER: Grove-Laugesen D

PROVIDER: S-EPMC7265727 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Arterial Stiffness and Blood Pressure in Patients Newly Diagnosed with Graves' Disease Compared with Euthyroid Controls.

Grove-Laugesen Diana D Malmstroem Sofie S Ebbehoj Eva E Riis Anne Lene AL Watt Torquil T Rejnmark Lars L Würgler Hansen Klavs K

European thyroid journal 20200214 3

<h4>Introduction and objective</h4>The excess cardiovascular morbidity and mortality in hyperthyroidism and Graves' disease (GD) is inadequately understood. We aimed to elucidate whether well-established cardiovascular risk factors such as arterial stiffness in terms of pulse wave velocity (PWV) and blood pressure differ in GD and controls.<h4>Methods</h4>This was a cross-sectional study comparing 55 hyperthyroid patients with newly diagnosed GD and 55 euthyroid, population-based controls matche ...[more]

PMID: 32523891

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Project description:Background Arterial stiffness predicts the risk of cardiovascular events and all-cause mortality and is associated with age and hypertension. However, the magnitude of the relationship between blood pressure (BP) and progression of arterial stiffness is unclear, limiting our understanding of how arterial stiffness mediates clinical effects of hypertension and planning of clinical trials. Methods and Results Medline and EMBASE were searched for prospective studies reporting linear models between baseline BP and progression of arterial stiffness, with and without adjustment for demographic characteristics and baseline stiffness. Standardized and unstandardized β coefficients for pulse wave velocity were combined by fixed and random effects meta-analysis, weighted by the inverse variance. Of 566 fully reviewed articles from 30, 524 titles, 22 populations from 21 reports were included. In 9 cohorts, there were consistent, adjusted associations between baseline systolic BP and progression of arterial stiffness (11 781 patients; standardized β=0.041; 95% CI, 0.026-0.055; P<0.001; P value for heterogeneity=0.70), equivalent to a 1.14-m/s increase in standard carotid-femoral pulse wave velocity per decade per 20-mm Hg systolic BP, independent of age. Unstandardized, adjusted associations were similar (1762 patients; β=0.0047; 95% CI, 0.004-0.006; P<0.001; P value for heterogeneity=0.64), equivalent to a 0.94-m/s increase per decade per 20-mm Hg systolic BP. In limited studies, standardized associations between mean BP and arterial stiffness progression were not significant and heterogeneous (913 patients; β=0.039; 95% CI, -0.008 to 0.086; P=0.11; P value for heterogeneity=0.03). Conclusions Baseline systolic BP was associated with a clinically important progression of arterial stiffness, independent of age, providing a reference for the potential effect of arterial stiffness in mediating changes in clinical outcomes associated with hypertension and providing a reference value to aid clinical trial design.

Dataset Information

Arterial Stiffness and Blood Pressure in Patients Newly Diagnosed with Graves' Disease Compared with Euthyroid Controls.

Publications

Arterial Stiffness and Blood Pressure in Patients Newly Diagnosed with Graves' Disease Compared with Euthyroid Controls.

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