Clinical, laboratory and endothelium-modulating changes in patients with arterial hypertension comorbid with hypothyroidism

Mykola Ivanovych Shved; Larysa Petrivna Martynyuk; Marta Andriivna Orel; Volodymyr Vladyslavovych Hnatko; Iryna Oleksandrivna Yastremska

Mykola Ivanovych Shved Department of Emergency Medical Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Larysa Petrivna Martynyuk Department of Emergency Medical Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Marta Andriivna Orel Department of Emergency Medical Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Volodymyr Vladyslavovych Hnatko Department of Ultrasound Diagnostics, Ternopil Regional Clinical Hospital, Ternopil, Ukraine
Iryna Oleksandrivna Yastremska Department of Emergency Medical Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Keywords: endothelial dysfunction, endothelium-dependent vasodilation, high blood pressure, hypothyroidism, lipids, thyroid-stimulating hormone, risk factor

Abstract

Endothelial dysfunction is one of the early pathogenetic signs and a universal predictor of various diseases, including arterial hypertension, atherosclerosis, cerebrovascular pathology, metabolic syndrome, diabetes and others. Functional impairment of the vascular endothelium can deepen under the influence of innate and pathological factors. Up to the present, the effect of thyroid hormones on the state of the endothelium has not been sufficiently studied. The purpose of the research was to study the characteristics of changes in the functioning of endothelium in patients with arterial hypertension comorbid with hypothyroidism and to investigate the relationships between endothelium-dependent vasodilatation of the brachial artery and the main clinical and anthropometric indicators, blood pressure levels and biochemical blood parameters in this cohort of patients. The study included 99 patients with stage 2 arterial hypertension, who were divided into 3 groups depending on the functional state of their thyroid gland. All examinees were measured height, body weight, body mass index, waist circumference and blood pressure. Disorders of carbohydrate metabolism and imbalance of lipid spectrum were studied based on the results of biochemical blood analysis. Endothelium-dependent vasodilatation was evaluated based on the results of cuff test. The statistical analysis was performed using MS Excel 2016 and Statistica 10 software applications. The result of the research showed that among patients with hypertension comorbid with hypothyroidism a decrease in the hormone-producing function of their thyroid gland and an increase in the level of thyroid-stimulating hormone is an additional factor in endothelium dysfunction. A reliable negative correlation of medium strength was found between endothelium-dependent vasodilatation indicators and thyroid-stimulating hormone levels in such patients, which endorses the expediency of the reduced thyroid function compensation together with an adequate antihypertensive therapy.