title: Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study.
abstract: BACKGROUND
  Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP) and diastolic (DAP) arterial pressure in euthyroid subjects.
  
  
  METHODS
  311 euthyroid individuals (185 women, mean age 43.9 +/- 9) without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6%) were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated.
  
  
  RESULTS
  TSH range was 0.1-8, median 1.4 mU/L, fT4 range was 11.5-25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p < 0.03, for both associations). In the subgroup of individuals with TSH levels 0.36-2.5 mU/L, both TSH and the "fT4.TSH product" were positively correlated with SAP (r = +0.133 p = 0.044, r = +0.152 p = 0.026) and DAP (r = +0.243 p < 0.001, r = +0.252 p < 0.001 respectively); in multivariate analysis the "fT4.TSH product" was a significant predictor of DAP independently of HOMA-IR and BMI (p < 0.001). Similar associations were found when only the non-hypertensive subjects were analysed (p = 0.004). Hypertensive patients had higher TSH levels (p = 0.02) and belonged more frequently to the subgroup with TSH > 2 mU/L (35.3% vs 21.3%, p = 0.045).
  
  
  CONCLUSIONS
  In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.
authors.affiliation: Endocrine Unit, Evgenidion Hospital, Athens University School of Medicine, Athens, Greece. mani@otenet.gr.
authors.forename: Katerina
authors.initials: K
authors.lastname: Saltiki
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Voidonikola
authors.forename: Kimon
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: Emily
authors.initials: E
authors.lastname: Mantzou
authors.forename: Christos
authors.initials: C
authors.lastname: Papamichael
authors.forename: Maria
authors.initials: M
authors.lastname: Alevizaki