A hospital based cross sectional study on subclinical hypothyroidism in females over fifty years of age and its relation to hypertension, diabetes mellitus and ischemic heart disease at a tertiary care hospital, Hyderabad

Arun Kumar Palakurthi, Krishna Chaitanya Alam


Background: Prevalence of subclinical hypothyroidism is more common in females compared to males and elderly age group. More studies are required to throw light on these aspects especially among elderly women with subclinical hypothyroidism and its association with prevalence of hypertension, diabetes and ischemic heart disease (IHD) among these women. The objective was to study prevalence of subclinical hypothyroidism among elderly females and its relation with the diabetes, hypertension and IHD.

Methods: Hospital based cross-sectional study was carried out among 178 women of 50 years and more. Detailed history, clinical examination and routine investigations were carried out. Free T4, free T3 and TSH (thyroid stimulating hormone) levels were measured using electro chemiluminescent method. Presence of hypertension, diabetes mellitus, IHD was noted.

Results: Prevalence of subclinical hypothyroidism was 24.7% and more in 61-70 years (38.5%). In 55% of the women the symptoms were absent. The most common symptom was fatigability and constipation. The prevalence of IHD among women with subclinical hypothyroidism was 22.7% compared to only 7.5% in women without subclinical hypothyroidism and this difference was found to be statistically significant (p<0.05). For hypertension and diabetes, it was observed that the prevalence of these two conditions was slightly more in women without subclinical hypothyroidism but the difference was not found to be statistically significant (p>0.05).

Conclusions: Prevalence of subclinical hypothyroidism in the elderly women was high. Subclinical hypothyroidism was found to be significantly associated with IHD but not with hypertension and diabetes.


Subclinical hypothyroidism, Age, Relation, Diabetes, Hypertension

Full Text:



Vahab F. Subclinical hypothyroidism: An update for primary care physicians. Mayo Clin Proc. 2009;84(1):65-71.

Cooper DS. Subclinical hypothyroidism. N Engl J Med. 2001;345:260-5.

Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in the community: the Whickham Survey. Clin Endocrinol. 1977;7(6):481-93.

Akbar DH, Ahmed MM, Hijazi NA. Subclinical hypothyroidism in elderly women attending an outpatient clinic. Med Sci Monit. 2004;10(5):229-32.

Bashir H, Farooq R, Bhat MH, Majid S. Increased prevalence of subclinical hypothyroidism in females in mountainous valley of Kashmir. Indian J Endocr Metab. 2013;17(2):276-80.

Parle JV, Franklyn JA, Cross KW, Jones SC, Sheppard MC. Prevalence and follow-up of abnormal thyrotropin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol. 1993;34(1):77-83.

Suh S, Kim DK. Subclinical hypothyroidism and cardiovascular disease. Endocrinol Metab (Seoul). 2015;30(3):246-51.

Kim TH, Choi HS, Bae JC, Moon JH, Kim HK, Choi SH, et al. Subclinical hypothyroidism in addition to common risk scores for prediction of cardiovascular disease: a 10-year community-based cohort study. Eur J Endocrinol. 2014;171(5):649-57.

Dean JW, Fowler PB. Exaggerated responsiveness to thyrotrophin releasing: a risk factor in women with coronary artery disease. Br Med J (Clin Res Ed) 1985;290(6481):1555-61.

Heinonen OP, Gordin A, Aho K, Punsar S, Pyorala K, Puro K. Symptomless autoimmune thyroiditis in coronary heart disease. Lancet. 1972;1(7754):785-6.

Hak AE, Pols HAP, Visser T, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam study. Ann Intern Med. 2000;132(4):270-8

Linderman RD, Schade DS, Rue AL, Romero LJ, Liang HC, Baumgartner RN, et al. Subclinical hypothyroidism in abeithnic, urban community. Am J Geriatric Soc. 1999;47(6):703-9.

Vanderpump MP, Tunbridge WMG, French M. The incidence of thyroid disorder in the community, a twenty year follow up of the Whickham survey. Clin Endocrinol. 1995;43(1):55-68.

Sawin CT, Castelli WP, Hershman M. The aging thyroid. Thyroid deficiency in Framingham Study. Arch Intern Med. 1985;145(8):1386-8.

Pinch C, Mullner M, Sinzinger H. Prevalence and relevance of thyroid dysfunction in 1922 cholesterol screening participants. J Clin Epidemiol. 2000;53(6):623-9.

Zulewski H, Muller B, Exer P, Miserez AR, Staub JJ. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and control. J Clin Endocrinol Metab. 1997;82(3):771-6.

Kong WM, Sheikh MH, Lumb PJ, Freedman DB, Crook M, Dore CJ, et al. A six-month randomized trial of thyroxin treatment in women with subclinical hypothyroidism. Am J Med. 2002;112(5):348-54.

Meier C, Roth CB, Huber G. Clinical and metabolic effect of thyroxin replacement in patients with mild thyroid failure, results from a double blind, placebo-controlled study. Endocr Soc. 2004;2372:573.

Jaeshke R, Guyatt G, Gerstein H, Patterson C, Molloy W, Cook D, et al. Does treatment with L-thyroxine influence the status in middle aged and older adults with subclinical hypothyroidism? J Intern Med. 1996;11(12):744-9.

Prasad I, Kumar U, Saran A, Kumari R, Keshari JR, Kumari B. Serum lipid status in subclinical hypothyroidism. Int J Sci Stud. 2016;4(3):77-81.

Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obes Relat Metab Disord. 2000;24(2):109-12.

Miura S, Litaka M, Suzuki S. Decrease in serum levels of thyroid hormone in patients with coronary heart disease. Endocrin J. 1996;43;657-63.

Kahaly GJ. Cardiovascular and atherogenic aspects of subclinical hypothyroidism. Thyroid. 2000;10(8):665-79.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160(4):526-34.

Raza SA, Mahmood N. Subclinical hypothyroidism: controversies to consensus. Indian J Endocrinol Metab. 2013;17(3):636-42.