Overt Hypothyroidism May Up All-Cause Mortality in the Elderly

However, no association seen between hypothyroidism and cardiovascular mortality
thyroid anatomy
thyroid anatomy

MONDAY, Dec. 23, 2019 (HealthDay News) -- Hypothyroidism is significantly associated with increased all-cause mortality, but not cardiovascular mortality, among the elderly, according to a review published online Dec. 12 in the Journal of Clinical Endocrinology & Metabolism.

Tou-Yuan Tsai, M.D., from the Dalin Tzu Chi Hospital in Chiayi, Taiwan, and colleagues conducted a systematic literature review to identify studies evaluating the association between hypothyroidism and all-cause and/or cardiovascular mortality among older adults (aged ≥60 years).

Based on 27 cohort studies (total 1,114,638 participants), the researchers found that patients with hypothyroidism experienced a higher risk for all-cause mortality than those with euthyroidism (pooled relative risk [RR], 1.26; 95 percent confidence interval [CI], 1.15 to 1.37). There was no significant difference in cardiovascular mortality between patients with hypothyroidism and those with euthyroidism (pooled RR, 1.10; 95 percent CI, 0.84 to 1.43). The increased risk for all-cause mortality was associated with overt hypothyroidism (pooled RR, 1.10; 95 percent CI, 1.01 to 1.20) rather than subclinical hypothyroidism (pooled RR, 1.14; 95 percent CI, 0.92 to 1.41). Study heterogeneity resulted from different study designs (prospective and retrospective) and geographic locations (Europe, North America, Asia, and Oceania).

"Our findings imply that individuals with subclinical hypothyroidism -- those who have milder thyroid dysfunction -- may not benefit from being treated with synthetic thyroid hormone," a coauthor said in a statement. "However, treatment should be considered in individuals diagnosed with hypothyroidism, given increased all-cause mortality."

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