title: Blood pressure, thyroid-stimulating hormone, and thyroid disease prevalence in primary aldosteronism and essential hypertension.
abstract: BACKGROUND
  A positive correlation between thyroid-stimulating hormone (TSH) and blood pressure (BP) has been identified in normotensives and in patients with essential hypertension (EH). This study was designed to evaluate, in primary aldosteronism (PA) and in EH, potential association of BP, TSH, and ultrasonographic changes of the thyroid.
  
  
  METHODS
  We studied 188 patients: 92 with PA and 96 matched essential hypertensives. Clinical and ambulatory BP (ABP), and thyroid function were evaluated in all patients. In PA and in a subgroup of EH patients (n = 65) thyroid ultrasonography was performed.
  
  
  RESULTS
  In PA patients, diastolic office and diastolic ABP increased across TSH quartiles and multivariate analysis confirmed a positive significant correlation between TSH and diastolic BP, independently of aldosterone levels, body mass index (BMI), duration of hypertension, and age. In EH patients, we found a significant linear increase in systolic and diastolic ABP with increasing TSH. The prevalence of thyroid dysfunctions was similar in PA and EH (15% and 19%, respectively). In PA patients, we found a higher prevalence of ultrasonographic alterations than in EH (66% vs. 46%, P < 0.05). PA patients presenting morphological abnormalities had higher homeostasis model assessment-insulin resistance levels than patients with normal gland at ultrasonography (4.2 ± 1.8 vs. 3.1 ± 0.8 P < 0.05).
  
  
  CONCLUSIONS
  We found a positive correlation between TSH and BP both in PA and EH patients. Moreover, in PA patients we observed a high prevalence of thyroid morphological alterations.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti Umberto I-G.M. Lancisi-G. Salesi, Ancona, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Turchi
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ronconi
authors.forename: Valentina
authors.initials: V
authors.lastname: di Tizio
authors.forename: Marco
authors.initials: M
authors.lastname: Boscaro
authors.forename: Gilberta
authors.initials: G
authors.lastname: Giacchetti
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013959:Thyroid Diseases / Q000453:epidemiology*; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013972:Thyrotropin / Q000097:blood* / Q000502:physiology; D014463:Ultrasonography
chemical_list: D000450:Aldosterone; D013972:Thyrotropin