• Darya S. Abdulateef Department of Physiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Taha O. Mahwi Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Sherwan H. Omer Department of Physiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Shadan J. Abdullah Shar Hospital, Ministry of Health, Sulaimani, Kurdistan Region, Iraq.



Systolic blood pressure, Diastolic blood pressure, TSH, FT4, Mild SCH, Euthyroid



Overt hypothyroidism affects the cardiovascular system and blood pressure regulation. There is controversy on the relation of subclinical hypothyroidism (SCH) with the cardiovascular system, and this relation is not assessed yet in mild SCH (SCH with TSH < 10 mIU/L).


To find differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, and pulse rate between mild SCH and Euthyroidism, furthermore to evaluate the relationship of these cardiovascular characteristics.


This prospective case-control study involved 186 participants; 43 mild SCH and 142 Euthyroid. The studied subjects were further subdivided into two groups according to age. Pulse rate and blood pressure (SDP and DBP) were measured, and mean and pulse pressure were calculated. The following biochemical parameters were measured; fasting plasma glucose (FPG) and thyroid function test (TFT; TSH, FT4, FT3, and anti-TPO antibody). The parameters were compared between SCH and Euthyroid groups using Student T-test and the correlation between variables was assessed using Pearson’s correlation, with a P-value ≤ of 0.05 is regarded as significant.


The mean TSH level in the mild SCH group is 5.47 (0.89) mIU/L. Mild SCH has higher DBP compared to Euthyroid subjects (81.93 vs 77.64 mmHg), and in the age group of <35 years, each of the DBP, SBP, and mean pressure were higher in SCH compared to control individual, in this group, there is a significant inverse correlation between FT4 and DBP. And in subjects with >35 years significant inverse correlation exists between FT4 and mean pressure, P < 0.05. No significant association is present between TSH level and pulse rate, blood pressure, and pulse pressure. 


Data of the present study revealed that even mild SCH, is associated with higher DBP compared to Euthyroid subjects and the FT4 level in the SCH has a negative correlation with DBP, while there was no significant correlation between pulse pressure, pulse rate with thyroid function test in subject with mild SCH. Follow-up of mild SCH subjects is recommended for blood pressure assessment.


Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev [Internet]. 2008;29(1):76–131. Available from: DOI:

Klein I, Ojamaa K. Thyroid Hormone and the Cardiovascular System. Epstein FH, editor. N Engl J Med [Internet]. 2001 Feb 15 [cited 2019 Oct 21];344(7):501–9. Available from: DOI:

Danzi S, Klein I. Thyroid hormone and blood pressure regulation. Curr Hypertens Rep. 2003;5(6):513–20. DOI:

Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007 Oct;116(15):1725–35. DOI:

Danzi S, Klein I. Thyroid disease and the cardiovascular system. Endocrinol Metab Clin North Am [Internet]. 2014;43(2):517–28. Available from: DOI:

Berta E, Lengyel I, Halmi S, Zrínyi M, Erdei A. Hypertension in Thyroid Disorders. 2019;10(July):1–11. DOI:

Ye Y, Xie H, Zeng Y, Zhao X, Tian Z, Zhang S. Association between subclinical hypothyroidism and blood pressure - A meta-analysis of observational studies. Endocr Pract [Internet]. 2014 Feb 1 [cited 2020 Mar 15];20(2):150–8. Available from: DOI:

Åsvold BO, Bjøro T, Nilsen TIL, Vatten LJ. Association between blood pressure and serum thyroid-stimulating hormone concentration within the reference range: A population-based study. J Clin Endocrinol Metab. 2007;92(3):841–5. DOI:

Messerli FH, Hofstetter L, Victor R, Cerny D. Hypothyroidism as a cause of secondary hypertension - Myth dispelled. J Am Soc Hypertens. 2017 Oct;11(10):615. DOI:

Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: Beneficial effect of levothyroxine therapy. J Clin Endocrinol Metab [Internet]. 2003 Aug 1 [cited 2020 Mar 16];88(8):3731–7. Available from: DOI:

Rodondi N, den Elzen WPJ, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA - J Am Med Assoc [Internet]. 2010 Sep 22 [cited 2020 Mar 15];304(12):1365–74. Available from: DOI:

Chu JW, Crapo LM. Should mild subclinical hypothyroidism be treated? Am J Med. 2002 Apr 1;112(5):422–3? DOI:

Peeters RP. Subclinical Hypothyroidism. Solomon CG, editor. N Engl J Med. 2017 Jun 29;376(26):2556–65. DOI:

Wartofsky L, and Dickey RA. The Evidence for a Narrower Thyrotropin Reference Range Is Compelling. J Clin Endocrinol Metab. 2005;90(9):5483–8. DOI:

Fatourechi V. Subclinical Hypothyroidism : An Update for Primary Care Physicians. Mayo Clin Proc. 2009;84(1):65–71. DOI:

Spencer CA, Hollowell JG, Kazarosyan M, and Braverman LE. National Health and Nutrition Examination Survey III Thyroid-Stimulating Hormone (TSH)-thyroperoxidase antibody relationships demonstrate that TSH upper reference limits may be skewed by occult thyroid dysfunction. J Clin Endocrinol Metab. 2007;92(11):4236–40. DOI:

Abdulateef DS, Mahwi TO. Assessment of subclinical hypothyroidism for a clinical score and thyroid peroxidase antibody: A comparison with euthyroidism grouped by different thyroid-stimulating hormone levels. Asian Biomed. 2019;13(3):85–93. DOI:

Gumieniak O, Perlstein TS, Hopkins PN, Brown NJ, Murphey LJ, Jeunemaitre X, et al. Thyroid function and blood pressure homeostasis in euthyroid subjects. J Clin Endocrinol Metab. 2004 Jul;89(7):3455–61. DOI:

Fommei E. The Role of Thyroid Hormone in Blood Pressure Homeostasis: Evidence from Short-Term Hypothyroidism in Humans. J Clin Endocrinol Metab [Internet]. 2002 May 1 [cited 2019 Oct 21];87(5):1996–2000. Available from: DOI:

Canbolat IP, Belen E, Bayyigit A, Helvaci A, Kilickesmez K. Evaluation of daily blood pressure alteration in subclinical hypothyroidism. Acta Cardiol Sin. 2017;33(5):489–94.

Maleki N, Kazerouni F, Hedayati M, Rahimipour A, Maleki MH. The Effect of Subclinical Hypothyroidism on Blood Pressure. Vasc Dis Manag. 2016;13(3): E67–74.

Nagasaki T, Inaba M, Kumeda Y, Hiura Y, Shirakawa K, Yamada S, et al. Increased pulse wave velocity in subclinical hypothyroidism. J Clin Endocrinol Metab [Internet]. 2006 Jan [cited 2020 Mar 19];91(1):154–8. Available from: DOI:

Luboshitzky R, Herer P. Cardiovascular risk factors in middle-aged women with subclinical hypothyroidism. Neuro Endocrinol Lett [Internet]. 2004 Aug [cited 2020 Mar 19];25(4):262–6. Available from:

Takashima N, Niwa Y, Mannami T, Tomoike H, Iwai N. Characterization of Subclinical Thyroid Dysfunction From Cardiovascular and Metabolic Viewpoints. Circ J [Internet]. 2007 [cited 2020 Mar 18];71(2):191–5. Available from: DOI:

Ko GTC, Wai HPS, Tang JSF. Effects of age on plasma glucose levels in non-diabetic Hong Kong Chinese. Croat Med J. 2006 Oct;47(5):709–13.

Saltiki K, Voidonikola P, Stamatelopoulos K, Mantzou E, Papamichael C, Alevizaki M. Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study. Thyroid Res. 2008;1(1):3. DOI:

Iqbal A, Figenschau Y, Jorde R. Blood pressure in relation to serum thyrotropin: The Tromsø study. J Hum Hypertens. 2006 Dec;20(12):932–6. DOI:



How to Cite

Abdulateef D, Mahwi T, Omer S, Abdullah S. RELATION OF THYROID FUNCTIONS WITH PULSE RATE, BLOOD PRESSURE, AND PULSE PRESSURE IN MILD SCH AND EUTHYROID SUBJECTS. JSMC [Internet]. 2021 Jun. 21 [cited 2024 Apr. 17];11(2):215-22. Available from:

Similar Articles

1-10 of 117

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)