Review
Published: 2017-09-15

Relationship between thyroid dysfunction and heart failure in older people

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy
Heart failure Hypothyroidism Thyroid hormone Thyrotropin Elderly Atrial fibrillation

Abstract

Heart failure (HF) is one of the most common chronic diseases, affecting around 8% of older people, with an incidence
rate of 10 per 1000 person-years. Besides ageing and classical cardiovascular risk factors, it is well recognized
that HF may be worsened by endocrine alterations. The prevalence of thyroid dysfunction, similarly to HF,
increases with increasing age and, 5-15% of the entire older population, especially women, suffer from overt or
subclinical thyroid dysfunction. Thyroid and heart share a common embryologic origin and an intimate and complex
functional relationship and, cardiovascular effects are the most prominent features of thyroid dysfunction.
Not only alterations of thyroid hormone synthesis and release are risk factors for cardiac disease, but a mutual
relationship has been documented and dysregulation of thyroid hormones represents also a marker for chronic
heart disease. Thus, even mild thyroid dysfunction (either in excess or defect) may lead to the development of
HF and may increase the risk of cardiovascular events. Consequently, thyroid dysfunction should be ruled out
not only in older HF patients with no other identifiable causes but also in those with known cardiovascular risk
factors. Nonetheless, the lack of randomized clinical trials leaves us with several unresolved key issues as also
stated in the latest guidelines for the treatment of thyroid dysfunction, .key issues regarding specific criteria and
goals of treatment, as also stated. Future large randomized intervention studies, balancing the risk and benefits
of thyroid therapy according to the degree of serum TSH and TH alteration, are clearly warranted.

Affiliations

G. Pasqualetti

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

F. Niccolai

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

V. Calsolaro

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

G. Bini

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

N. Caraccio

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

F. Monzani

Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2017

How to Cite

[1]
Pasqualetti, G., Niccolai, F., Calsolaro, V., Bini, G., Caraccio, N. and Monzani, F. 2017. Relationship between thyroid dysfunction and heart failure in older people. JOURNAL OF GERONTOLOGY AND GERIATRICS. 65, 03 Special (Sep. 2017), 184-191.
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