Analysis On Clinical Characteristics Of Patients With Primary Hypertension Combined With Subclinical Hypothyroidism

Objective: To understand the clinical features of subclinical ypothyroidism(SCH)in patients with primary hypertension,explore the correlations between risk factors and target organ damage,and provide evidence for early clinical diagnosis and treatment.Methods: All primary hypertention patients in the department of cardiology of one hospital from January 2015 to December 2017 were chosen as the subjects of the study.3,221 patients were selected by ranging the concrete retrieval time and conditions in the medical record retrieval system.Among all the above 3,221 subjects,207 patients combined with SCH were selected as SCH group,and 165 patients combined without SCH were selected as control group.General demographic characteristics of SCH group and control group were collected,thyroid function,blood routine,liver function,and kidney function were tested,the medicine-using and echocardiogram were investigated,respectively.The SPSS 24.0 statistical software package was used for data processing and analysis.General statistical description,paired t test,ANOVA,Pearson correlation analysis,and multivariate logistic regression analysis were used.Results:1.Compared with the control group,age composition in SCH group were higher(59.16±11.16 vs 63.98±8.19,P=0.001),and female composition in SCH group were higher(53.33% vs 73.43%,P=0.001),but the smoking rate in SCH group was lower(27.27% vs 14.98%,P=0.003).2.The TSH levels in SCH group was significantly higher(Z=16.523,P=0.001),yet FT3 levels in SCH group was lower(t=3.485,P=0.001),comparing with the control group.FT3 levels of all the study subjects showed the decreasing-tendency with increasing-age.There was no statisticallysignificant difference on FT4 levels between SCH group and control group(P>0.05).Compared with the male in two group,TSH level in female was obviously higher(Z=-4.323,P=0.001),yet FT3 level in female was lower(t=-2.821,P=0.005).Level of FT4 have no difference.3.Compared with the control group,the diastolic blood pressure in SCH group was lower than that in control group(t=3.101,P=0.002).Furthermore,FT3 level of the control group decreased with the increase of blood pressure,and the difference was statistically significant(F=5.180,P=0.007).4.The erythrocyte count and hemoglobin level in SCH group were lower than control group(t=2.678,P=0.008;t=2.133,P=0.034),yet globulin,glycosylated hemoglobin,fibrinogen quantitative,and urea nitrogen level in SCH group were significantly higher than those in control group(P<0.05).Velocity of E and A peak in echocardiogram in SCH group were both higher than those in control group(t=-2.927,P=0.004;t=-2.299,P=0.022).The LVEF in SCH group was lower than that in control group,and the difference was statistically significant(t=2.189,P=0.029).5.The percentage of medicine taking,including anticoagulant,antith rombotic,nitrates,beta blockers,and ACEI,were all higher than those i n the control group(P<0.01).6.Co-morbidity,Unstable angina pectoris(42.51%),myocardial infar ction(10.14%),arrhythmia(41.55%),and diabetes(31.40%)in SCH group were all higher than those in the control group(32.12%,0,26.06%,13.33%,P<0.05).7.Pearson correlation analyses showed,in both SCH group and control group,the RBC count was negatively correlated with TSH levels(r=-0.124,P=0.017),but positively correlated with FT3 levels(r=0.023,P=0.001).In addition,hemoglobin level was positively correlated with FT3 level(r=0.268,P=0.001),and echocardiogram A peak was positively correlated with TSH and FT4(r=0.116,P=0.034;r=0.114,P=0.037).LVEF was negatively correlated with TSH(r=-0.142,P=0.008),while positively correlated with FT3(r=0.176,P=0.001).8.Multivariate logistic regression analysis showed that female,age and the diabetes,RBC decrease,and total cholesterol increase,as well as LVEF decrease in patients' echocardiogram detection might predict the risks in hypertension patients combined with SCH.Conclusions:1.The level of FT3 in hypertension patients combined with SCH obviously decreased with the increasing-age.In the hypertension patients combined with SCH,the female morbidity were higher than the male.2.The hypertension patients combined with SCH had more possibility cardiovascular disease complications.3.Female,age,diabetes,RBC decrease,and total cholesterol increase,as well as LVEF decrease in patients' echocardiogram detection were significantly associated with symptoms of hypertension patients combined with SCH.So these might predict the risks in hypertension patients combined with SCH.