Thyroid-related Hormones and Hypertension Incidence in Middle-Aged and Older Hispanic/Latino Adults: The HCHS/SOL Study

Chibuzor Abasilim; Victoria Persky; Robert M Sargis; Maria Argos; Martha Daviglus; Sally Freels; Jianwen Cai; Konstantina Tsintsifas; Carmen R Isasi; Brandilyn A Peters; Gregory A Talavera; Bharat Thyagarajan; Mary E Turyk

doi:10.1210/jendso/bvae088

Thyroid-related Hormones and Hypertension Incidence in Middle-Aged and Older Hispanic/Latino Adults: The HCHS/SOL Study

J Endocr Soc. 2024 May 2;8(6):bvae088. doi: 10.1210/jendso/bvae088. eCollection 2024 Apr 6.

Authors

Affiliations

¹ Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA.
² Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA.
³ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
⁴ Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL 60612, USA.
⁵ Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
⁷ Department of Psychology, San Diego State University, San Diego, CA 92182, USA.
⁸ Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55415, USA.

Abstract

Background: Thyroid-related hormones act to regulate metabolic pathways and blood pressure (BP). However, the relationship of TSH and peripheral thyroid hormones and the role of the hypothalamic-pituitary-thyroid axis on hypertension development is not fully understood. We assessed sex-specific associations of thyroid-related hormones with BP and hypertension in Hispanic/Latino adults followed for 6 years.

Methods: We studied 1789 adults, ages 45 to 74, free of diabetes at baseline from a subcohort of the Hispanic Community Health Study/Study of Latinos. We assessed TSH, free T4 (FT4), T3, and various indicators of thyroid axis. Using multivariable linear and Poisson regression adjusted for survey design and confounding variables, we estimated a priori sex-specific associations of thyroid-related hormones with changes in BP and hypertension development.

Results: In men and women, TSH and TSH/FT4 ratios were associated with changes in diastolic BP and T3 with changes in pulse pressure and the development of hypertension from prehypertension. In men, a 1-SD increase in TSH [incident rate ratio (IRR) = 1.42; 95% confidence interval (CI): 1.15, 1.75] and TSH/FT4 ratio (IRR = 1.20; 95% CI: 1.07, 1.35) were positively associated with the development of hypertension from prehypertension while the TSH/FT4 ratio (IRR = 0.85; 95% CI: .72, 1.00) was protective in women. We observed sex-specific differences in associations of the T3/FT4 ratio and indices of pituitary sensitivity to thyroid hormones with changes in pulse pressure and hypertension development.

Conclusion: Thyroid-related hormones are associated with sex-specific changes in BP and hypertension among Hispanic/Latino adults consistent with selected studies conducted in other populations. Mechanisms underlying associations of pituitary sensitivity to thyroid hormones with BP and hypertension development warrant further study.

Keywords: Hispanic/Latino; hypertension; prehypertension; thyrotropin; thyroxine; triiodothyronine.