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This version published online on January 2, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2208
A more recent version of this article appeared on March 1, 2007
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Submitted on October 10, 2006
Accepted on December 26, 2006

Association between blood pressure and serum TSH concentration within the reference range: a population-based study

Bjørn O Åsvold*, Trine Bjøro, Tom IL Nilsen, and Lars J Vatten

Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Medical Biochemistry, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

* To whom correspondence should be addressed. E-mail: bjorn.o.asvold{at}ntnu.no.

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

Objective. To study the association between thyroid stimulating hormone (TSH) within the reference range and blood pressure.

Design and setting. Cross-sectional, population-based study.

Subjects. 30,728 individuals without previously known thyroid disease.

Main outcome measures. Mean systolic and diastolic blood pressure and pulse pressure, and odds ratio for hypertension (> 140/90 mmHg, 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/L), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mmHg (95% CI, 1.4 to 2.6 mmHg) per mU/L increase in TSH among men, and 1.8 mmHg (95% CI, 1.4 to 2.3 mmHg) in women. The corresponding increase in diastolic blood pressure was 1.6 mmHg (95% CI, 1.2 to 2.0 mmHg) in men, and 1.1 mmHg (95% CI, 0.8 to 1.3 mmHg) in women. Comparing TSH of 3.0-3.5 mU/L (upper part of the reference) with TSH of 0.50-0.99 mU/L (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI, 1.56 to 2.53) in men, and 1.23 (95% CI, 1.04 to 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.
Key words: Thyroid • Thyroid Stimulating Hormone • blood pressure • population study




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