WESTPORT, CT (Reuters Health) – The mechanisms that produce hypertension in patients with hyperthyroidism or hypothyroidism differ, with hypothyroid patients being more salt-sensitive than hyperthyroid patients, Polish researchers report.
Dr. Czeslaw Marcisz and colleagues from the Medical University of Silesia, Tychy, studied 75 patients with hyperthyroidism, 31 patients with hypothyroidism and 37 healthy controls. The patients with hyperthyroidism were assessed before treatment and 2 weeks after the start of treatments and again when they achieved a euthyroid state. Those with hypothyroidism were assessed before treatment and in the euthyroid state.
The researchers measured blood pressure, plasma volume, aldosterone levels, atrial natriuretic, vasopressin levels and plasma renin after the subjects had been on a normal sodium diet for 3 days and again after they had been on a low-sodium diet for 3 days, according to the report in the October issue of the American Journal of Hypertension.
Patients with both hyperthyroidism and hypothyroidism had elevated systolic blood pressure, but only hypothyroid patients had elevated mean arterial pressure.
On the low-salt diet, only untreated hypothyroid patients had decreases in systolic and diastolic blood pressure and mean arterial pressure, Dr. Marcisz's group found. Hypothyroid patients with salt-sensitive blood pressure also had lower increases in renin activity while on the low-sodium diet compared with those salt-resistant blood pressure, the researchers note.
Among hyperthyroid patients and controls, about the same proportion (25%) had salt-sensitive blood pressure, Dr. Marcisz's team points out.
The researchers conclude that "there was a significantly higher incidence of salt sensitivity in patients with hypothyroidism before treatment. It suggests that a deficiency in thyroid hormones increases the blood pressure response to salt restriction. The mechanism remains unclear."
Am J Hypertens 2001;14:995-1002.
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