PREVALENCE OF SUBCLINICAL HYPOTHYROIDISM IN ELDERLY PATIENTS WITH CARDIOVASCULAR DISEASE.

Background: The prevalence of sub clinical hypothyroidism (SCH) is relatively high and ranges from 4% to 20% in the adult population with more common in elderly. Elderly with SCH had higher risk of incident heart failure. Few studies reported the prevalence of thyroid dysfunction in elderly Egyptians especially coronary heart disease (CHD). The aim of our study was to estimate the prevalence of Subclinical hypothyroidism in elderly cardiac patients and to assess the relation between thyroid function, cardiovascular risk and severity of CHD in elderly. Methods: cross sectional study included 45 elderly Egyptian patients with cardiovascular disease and 45 healthy elderly subjects as controls. Cardiac patients were subdivided to ischemic (n=23) and hypertensive groups (n=22), ischemic group subdivided according to number of coronary artery occlusions. Serum level of FT4, FT3, TSH, lipid profile, fasting blood glucose were measured. Results: our results shows that, there were statistically significant higher levels of thyroid stimulating hormone (TSH), lipid profile, systolic and diastolic blood pressure in case group compared to control group. Additionally, There were statistically significant higher levels of TSH in ischemic cardiac group compared to hypertensive cardiac group (p <0.05), on the contrary there were no significant different as regard free T3 and T4 levels among studied groups. The prevalence of coronary artery occlusion in ischemic cardiac group was; normal (62.2%), single vessel disease (24.4%), two vessel disease (11.2%) and three vessel disease (2.2%). There was significant positive correlation between TSH levels and the number of coronary artery occlusion .In ischemic cardiac patients, linear regression analysis showed that TSH levels were independently correlated with TC, TG, LDL and HDL (P < 0.05). Conclusion: the prevalence of subclinical hypothyroidism in all cardiac group was (22%); in ischemic group (26%) and in hypertensive group (18%). Also, there was positive association between Subclinical Hypothyroidism, Hypertension, Dyslipidemia and CHD in elderly Patients.