Abstract
Thyroid hormone excess has complex metabolic effects, particularly on the cardiovascular
system. Treatment of these conditions is universally suggested by international guidelines.
Subclinical hyperthyroidism, defined by reduced or suppressed TSH levels in the presence
of normal free thyroxine and free triiodothyronine values, is common in the general
population and progressively increases with aging, being as high as 15.4% in subjects
more than 75 years old and more frequent in subjects with nodular goiter. Subclinical
hyperthyroidism is often asymptomatic and the diagnosis is incidentally made during
screening exams. However, this form of thyroid disorder has gained attention in the
last years for its association with cardiovascular disease, in particular with atrial
fibrillation. Less clear are the effects of subclinical hyperthyroidism on blood pressure,
stroke, or heart failure. The decision to treat subclinical hyperthyroidism is made
on the clinical judge, particularly in elderly patients and/or in the presence of
comorbidities.
Key words
thyroid disorders - cardiovascular disease - atrial fibrillation - heart failure -
stroke - mortality