Central hypothyroidism and cardiovascular disease: A Spanish cohort observational study

Purpose Little is known about cardiovascular (CV) risk in patients with central hypothyroidism (CeH). Herein, we describe prevalent and incident cardiovascular risk factors (CVRFs), cardiovascular diseases (CVDs), and mortality in adults with CeH. Methods and patients This was a multicenter, retrospective, observational study of patients with CeH treated at 14 tertiary hospitals in Spain. Results 637 patients, 339 (53.2%) males, with median age of 54 [IQR: 40–67] years, of which 582 (91.4%) had combined CeH and 55 (8.6%) isolated CeH were analyzed. At baseline, 218 (34.2%) had dyslipidemia, 200 (31.4%) hypertension and 84 (13.2%) diabetes. Also, 21 (3.3%) had history of myocardial infarction, 8 (1.3%) chronic coronary syndrome, 9 (1.4%) heart failure and 20 (3.1%) cerebrovascular disease. Median follow-up was 7.0 [3.3–11.8] years and 7 (1.1%) patients recovered other hormone deficiencies. At the last visit 575 (90.3%) had combined CeH and 62 (9.7%) isolated CeH. From diagnosis of CeH to the last visit, incident CVRFs included 182 (43.4%) patients with dyslipidemia, 104 (23.8%) hypertension and 67 (12.1%) diabetes, while incident CVDs comprised 16 (2.6%) myocardial infarction, 11 (1.7%) chronic coronary syndrome, 17 (2.7%) heart failure and 33 (5.3%) cerebrovascular disease. Incident CVRFs, most CVDs, and mortality were similar between combined and isolated CeH. During the follow-up, 46 (7.2%) patients died, 32.6% by infections, 21.7% by CVDs and 21.7% by malignancies. Conclusions CeH is associated with high prevalent CVRFs. Incident CVRFs, most CVDs and mortality are similar both in patients with isolated CeH and combined CeH.