Women with rheumatoid arthritis (RA) are at increased risk for hypothyroidism and its attendant cardiovascular complications, research suggests.
The study was undertaken by a team in The Netherlands who hypothesized that RA would be associated with other disorders with autoimmune components, such as hypothyroidism and atherosclerosis.
The researchers identified 358 RA patients who were participating in a separate prospective cohort study and classified them according to their thyroid status. Hyperthyroid individuals were excluded from the study.
Of the remainder, female RA patients were significantly more likely to have clinical hypothyroidism (6.8%) compared with males (2.7%) and compared with the general Dutch female population (2.5%).
Conversely, female RA patients were much less likely than males and the general population to be euthyroid.
In addition, female RA patients with clinically manifest hypothyroidism were significantly more likely to have cardiovascular disease than were euthyroid RA patients (37.5% vs 13.0%).
The association between hypothyroidism and cardiovascular disease in females remained strong and significant even after adjustment for multiple confounders, including traditional vascular risk factors, at an odds ratio of 4.6.
"This might indicate a synergistic detrimental effect of RA as well as hypothyroidism for the development of cardiovascular disease," write M Nurmohamed (VU University Medical Center, Amsterdam, The Netherlands) and study authors in the Annals of the Rheumatic Diseases.
"Hence, we should be aware of this amplified cardiovascular risk in hypothyroid female RA patients and consider screening for hypothyroidism in female RA patients."
I'd like to point out that hypothyroidism can be the result of our medications - in particular,