Subclinical Hypothyroidism in Geriatric Population and Its Association With Heart Failure

Abstract

Heart failure (HF) is one of the most common causes of hospitalization in the geriatric age group, above 65 years. It is associated with high morbidity, mortality, and bad prognosis. Subclinical hypothyroidism (SCH) is a common condition present in this age group that significantly affects the cardiovascular system. Thus, this review attempts to elaborate on the association between subclinical hypothyroidism and heart failure in terms of their prevalence, pathogenesis, prognosis, and possible management in a geriatric age group. Among the various published literature on this topic on PubMed, PubMed Central, and Google Scholar, 36 relevant studies were selected to correlate this association. We found that both SCH and HF can be present concurrently in this age group. Especially in the geriatric population with thyroid-stimulating hormone (TSH) higher than ten mIu/L, there is an increased incidence of heart failure and a worse prognosis with preexisting heart failure. However, randomized controlled trials will be needed to explore further whether treatment is warranted or not in this age group.

Keywords: elderly population; geriatric population; heart failure; heart failure prognosis; levothyroxine; subclinical hypothyroidism; thyroid dysfunction.

Figure 1. Common Effects of Subclinical Hypothyroidism

LDL: low-density lipoprotein

Figure 2. Pathogenesis of Subclinical Hypothyroidism and Heart Failure

TNF alpha: tumor necrosis factor-alpha; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; IL-6: interleukin-6; SERCA 2: sarco/endoplasmic reticulum calcium ATPase isoform 2