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Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

Department of Public Health (B.O. Å., T.I.L.N., L.J.V.), Faculty of Medicine, Norwegian University of Science and Technology, N-7489 Trondheim, Norway; St. Olavs Hospital, Trondheim University Hospital (B.O.Å.), N-7006 Trondheim, Norway; Department of Medical Biochemistry (T.B.), Rikshospitalet-Radiumhospitalet Medical Center, N-0310 Oslo, Norway

Address all correspondence and requests for reprints to: Bjørn Olav Åsvold, Department of Public Health, Faculty of Medicine, N-7489 Trondheim, Norway. E-mail: bjorn.o.asvold{at}ntnu.no.

Context: The association between thyroid function and blood pressure is insufficiently studied.

Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure.

Design and Setting: This was a cross-sectional, population-based study.

Subjects: A total of 30,728 individuals without previously known thyroid disease were studied.

Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (>140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH.

Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women.

Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

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