The Correlation between Free Triiodothyronine, Free Thyroxine and Hypertension in Depression Patients with Hypothyroidism and Its Clinical Guiding Value
Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P < 0.05). The FT3 level in group B was statistically significantly lower than that in group A (P < 0.05). Correlation analysis of hypertensive patients with hypothyroidism showed that hypertension was positively correlated with depression (rs = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P < 0.05). Logistic regression analysis showed that coronary heart disease, hyperlipidemia, FT3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P < 0.01), respectively. With the decrease of FT3, the risk of hypertension increased (P < 0.01); With the increase of FT4, the risk of hypertension significantly increased (P < 0.01). Conclusions: Depression patients with hypothyroidism are more likely to suffer from hypertension, coronary heart disease and hyperlipidemia. Coronary heart disease and hyperlipidemia can increase the risk of hypertension
References
[1]
Guha, M. (2014) Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th Edition). Reference Reviews, 28, 36-37. https://doi.org/10.1108/RR-10-2013-0256
[2]
McAtee, C. (2022) Hypertension. Critical Care Nursing Clinics of North America, 34, 373-381. https://doi.org/10.1016/j.cnc.2022.08.002
[3]
Rossi, A., Mikail, N., Bengs, S., Haider, A., Treyer, V., Buechel, R.R., et al. (2022) Heart-Brain Interactions in Cardiac and Brain Diseases: Why Sex Matters. European Heart Journal, 43, 3971-3980. https://doi.org/10.1093/eurheartj/ehac061
[4]
Ho, W.S.V., Hill, M.N., Miller, G.E., Gorzalka, B.B. and Hillard, C.J. (2012) Serum Contents of Endocannabinoids Are Correlated with Blood Pressure in Depressed Women. Lipids in Health and Disease, 11, Article No. 32. https://doi.org/10.1186/1476-511x-11-32
[5]
Jefferson, J.W. (1975) A Review of the Cardiovascular Effects and Toxicity of Tricyclic Antidepressants. Psychosomatic Medicine, 37, 160-179. https://doi.org/10.1097/00006842-197503000-00006
[6]
Shelton, R.C. (2019) Serotonin and Norepinephrine Reuptake Inhibitors. Handbook of Experimental Pharmacology, 250, 145-180. https://doi.org/10.1007/164_2018_164
[7]
Takita, Y., Takeda, Y., Fujisawa, D., Kataoka, M., Kawakami, T. and Doorenbos, A.Z. (2021) Depression, Anxiety and Psychological Distress in Patients with Pulmonary Hypertension: A Mixed-Methods Study. BMJ Open Respiratory Research, 8, e000876. https://doi.org/10.1136/bmjresp-2021-000876
[8]
Anand, B.K., Dua, S. and Malhotra, C.L. (1957) Effects of Reserpine on Blood-Pressure Responses Evoked from the Hypothalamus. British Journal of Pharmacology and Chemotherapy, 12, 8-11. https://doi.org/10.1111/j.1476-5381.1957.tb01353.x
[9]
Paykel, E.S., Fleminger, R. and Watson, J.P. (1982) Psychiatric Side Effects of Antihypertensive Drugs Other than Reserpine. Journal of Clinical Psychopharmacology, 2, 14-39. https://doi.org/10.1097/00004714-198202000-00004
[10]
Fischer, S. and Ehlert, U. (2017) Hypothalamic-pituitary-thyroid (HPT) Axis Functioning in Anxiety Disorders: A Systematic Review. Depression and Anxiety, 35, 98-110. https://doi.org/10.1002/da.22692
[11]
Tudoran, M., Tudoran, C., Ciocarlie, T. and Giurgi-Oncu, C. (2020) Aspects of Diastolic Dysfunction in Patients with New and Recurrent Depression. PLOS ONE, 15, e0228449. https://doi.org/10.1371/journal.pone.0228449
[12]
Tudoran, M. and Tudoran, C. (2015) Particularities of Endothelial Dysfunction in Hypothyroid Patients. Kardiologia Polska, 73, 337-343. https://doi.org/10.5603/kp.a2014.0241
[13]
Yu, M.Y., Lu, C., Feng, L.M., et al. (2020) Escitalopram Oxalate Combined with Levothyroxine Sodium in the Treatment of 30 Cases of Subclinical Hypothyroidism with Anxiety and Depression. Anhui Medicine, 24, 1655-1658.
[14]
Calvi, A., Fischetti, I., Verzicco, I., Belvederi Murri, M., Zanetidou, S., Volpi, R., et al. (2021) Antidepressant Drugs Effects on Blood Pressure. Frontiers in Cardiovascular Medicine, 8, Article 704281. https://doi.org/10.3389/fcvm.2021.704281
[15]
Zhang, L.L., Jia, J.H., Jin, Y.H., et al. (2021) Effect of 131I Combined with Paroxetine on Patients with Hyperthyroidism and Mood Disorders. International Journal of Psychiatry, 48, 76-78.
[16]
Xu, H.K., Zhang, X.G. and Tian, H.Y. (2018) Changes of Serum Thyroid Hormone Levels in Schizophrenia Patients with Depressive Symptoms. Contemporary Medicine, 24, 94-96.
[17]
Yang, Y.H. (2021) Effects of Escitalopram Combined with Quetiapine on Anxiety, Depression and Thyroid Function in Elderly Schizophrenia Patients with Depression. Modern Medicine and Health Research, 5, 142-144.
[18]
Luo, Y., Xie, C.Q. and Wei, Y.C. (2019) Effect of Felodipine Sustained-Release Tablets Combined with Escitalopram Oxalate Tablets on Serum Thyroid Hormone Levels in Patients with Hypertension and Depression. Drug Use Evaluation and Analysis in Chinese Hospitals, 19, 805-807.
[19]
Yang, L., Yang, X., Yang, T., Wu, X., Sun, P., Zhu, Y., et al. (2021) The Effect of Thyroid Function on the Risk of Psychiatric Readmission After Hospitalization for Major Depressive Disorder. Psychiatry Research, 305, Article ID: 114205. https://doi.org/10.1016/j.psychres.2021.114205
[20]
Dwyer, J.B., Aftab, A., Radhakrishnan, R., Widge, A., Rodriguez, C.I., Carpenter, L.L., et al. (2020) Hormonal Treatments for Major Depressive Disorder: State of the Art. American Journal of Psychiatry, 177, 686-705. https://doi.org/10.1176/appi.ajp.2020.19080848
[21]
Li, W.F., Tang, G.Z., Li, M., et al. (2019) Analysis of Thyroid Function in Female Patients with Depressive Episode. International Journal of Psychiatry, 46, 677-679.
[22]
Cai, H.R., Shu, L.B., Li, D.M., et al. (2018) The Relationship between Maternal Hypothyroidism during Pregnancy and Postpartum Anxiety and Depression. Chinese Modern Physicians, 56, 55-58.
[23]
Deng, X., Zhuang, W.L., Wei, J.L., et al. (2021) Anxiety and Depression in Postmenopausal Women with Diabetes Mellitus and Subclinical Hypothyroidism. Chinese Journal of Gerontology, 41, 3561-3564.
