THYROID DYSFUNCTION AND BLOOD PRESSURE COMPONENTS: MULTIVARIATE STATISTICAL ASSOCIATIONS

MEENAKSHISUNDARAM R.¹*, GROOTVELD M.², NIRUBHANBHARATHY R.V.³, NITHYA E.⁴, MAJELLA L.J.⁵, THIRUMALAIKOLUNDUSUBRAMANIAN P.^6
1Chennai Medical College Hospital and Research Centre, Irungalur, Trichy- 621 105, TN, India.
²Leicester School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK.
³Madurai Medical College, Madurai- 625 020, TN, India.
⁴Madurai Medical College, Madurai- 625 020, TN, India.
⁵Madurai Medical College, Madurai- 625 020, TN, India.
⁶Chennai Medical College Hospital and Research Centre, Irungalur, Trichy- 621 105, TN, India.
* Corresponding Author : rmsundarchandran@gmail.com

Received : 05-03-2014     Accepted : 23-06-2014     Published : 30-06-2014
Volume : 5     Issue : 1       Pages : 294 - 304
Int J Med Clin Res 5.1 (2014):294-304
DOI : http://dx.doi.org/10.9735/0976-5530.5.1.294-304

Keywords : Hyperthyroidism, hypothyroidism, thyroid biomarkers, thyroxine, thyroid stimulating hormone, SBP, DBP, MAP, SBP:DBP ratio, body mass index, blood pressure, hypertension
Conflict of Interest : None declared
Acknowledgements/Funding : We would like to acknowledge and thank, the Ethical committee and Dean of Chennai Medical College Hospital and Research Centre, India, for their valuable support in the com-pletion of this project.

Background: Although thyroid dysfunctions exert significant effects on blood pressure (BP), published literature available has revealed con-tradictory data. Objectives: To explore the inter-relationships between selected thyroid dysfunctional status (hyper and hypothyroid conditions) and estab-lished biomarkers [thyroid stimulating hormone (TSH) and thyroxine (T4)]; and BP components [specifically Systolic BP (SBP), Diastolic BP (DBP), and Mean Arterial Pressure (MAP), and uniquely SBP:DBP ratio]. Materials and Methods: We followed rigid criteria in order to select adults with hyperthyroidism (n=71) and hypothyroidism (n=300), together with healthy age-matched controls (n =300), and applied a series of statistical analysis strategies to the datasets acquired. Results: Univariate statistical analyses of the SBP:DBP ratio by ANOVA and ANCOVA revealed that its mean value was significantly greater in hyperthyroid patients than those of healthy control and hypothyroid subjects (p˂0.0001). Body mass index (BMI) was significantly elevated in hypothyroid patients over those of healthy control and hyperthyroid subjects (p˂0.0001); healthy controls had a significantly greater BMI value than that of hyperthyroid patients (p˂0.0001). Multivariate (MV) analysis [redundancy analysis (RDA), canonical correlation analysis (CCorA), and principal component analysis (PCA)] demonstrated powerful relationships between all blood pressure components and thyroid disease classifications, together with their biomarker indices and further patient-related parameters. Conclusions: Since thyroid dysfunctional status is associated with elevated BP, and increasing BP is positively-correlated with elevated se-rum thyroid biomarkers, hyper and hypothyroid disorders should be recognized and treated early in order to avoid critical hazards presented by high BP.

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