Tachycardia in hyperthyroidism: Not so common
The commonly held association of hyperthyroidism with sinus tachycardia and widened pulse pressure (PP) has not been reassessed in decades despite patients with hyperthyroidism in current practice not always present with these signs. The study objective was to assess prevalence and variability of si...
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| Veröffentlicht in: | PloS one 2022-09, Vol.17 (9), p.e0273724-e0273724 |
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| description | The commonly held association of hyperthyroidism with sinus tachycardia and widened pulse pressure (PP) has not been reassessed in decades despite patients with hyperthyroidism in current practice not always present with these signs. The study objective was to assess prevalence and variability of sinus tachycardia and widened PP in present day among individuals with different degrees of hyperthyroidism. Data was collected retrospectively from 248 adult patients in an outpatient setting with biochemical evidence of hyperthyroidism, recorded heart rate (HR) and blood pressure (BP) who were not treated with medications that can influence these parameters. Mean age was 42.0 ± 14.2 years with 66.9% being female. Median free thyroxine (fT4) level was 3.49 (IQR 2.42-4.58) ng/dL and thyroid stimulating hormone (TSH) 0.02 (IQR 0.01-0.03) mIU/L. Tachycardia, defined as HR >100 bpm, was present in 28.2%. In the lowest and highest fT4 quartiles, tachycardia was present in 16.4% and 38.7% respectively. Using logistic regression, tachycardia was associated with higher fT4 and diastolic BP. More lenient outcome of tachycardia with HR >90 bpm was seen in 47.2%. Widened PP, defined as >50 mmHg, was observed in 64.1% of patients and correlated with higher fT4 and BP. Tachycardia is not a common feature of hyperthyroidism today. The relatively infrequent finding of tachycardia in this study compared to older studies may reflect differences in the way medicine is practiced today. The increased ordering of thyroid function tests most likely unmasked cases of mild or asymptomatic thyrotoxicosis. A widened PP was a more prevalent clinical finding in this study. |
| doi_str_mv | 10.1371/journal.pone.0273724 |
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The study objective was to assess prevalence and variability of sinus tachycardia and widened PP in present day among individuals with different degrees of hyperthyroidism. Data was collected retrospectively from 248 adult patients in an outpatient setting with biochemical evidence of hyperthyroidism, recorded heart rate (HR) and blood pressure (BP) who were not treated with medications that can influence these parameters. Mean age was 42.0 ± 14.2 years with 66.9% being female. Median free thyroxine (fT4) level was 3.49 (IQR 2.42-4.58) ng/dL and thyroid stimulating hormone (TSH) 0.02 (IQR 0.01-0.03) mIU/L. Tachycardia, defined as HR >100 bpm, was present in 28.2%. In the lowest and highest fT4 quartiles, tachycardia was present in 16.4% and 38.7% respectively. Using logistic regression, tachycardia was associated with higher fT4 and diastolic BP. More lenient outcome of tachycardia with HR >90 bpm was seen in 47.2%. Widened PP, defined as >50 mmHg, was observed in 64.1% of patients and correlated with higher fT4 and BP. Tachycardia is not a common feature of hyperthyroidism today. The relatively infrequent finding of tachycardia in this study compared to older studies may reflect differences in the way medicine is practiced today. The increased ordering of thyroid function tests most likely unmasked cases of mild or asymptomatic thyrotoxicosis. A widened PP was a more prevalent clinical finding in this study.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0273724</identifier><identifier>PMID: 36054093</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Age ; Antihypertensives ; Beta blockers ; Biology and Life Sciences ; Blood pressure ; Cardiac arrhythmia ; Cardiac function ; Clinical medicine ; Clinics ; Complications and side effects ; Correlation analysis ; Development and progression ; Gene expression ; Heart rate ; Hormones ; Hypertension ; Hyperthyroidism ; Medicine and Health Sciences ; Patients ; Physical Sciences ; Quartiles ; Regression analysis ; Research and Analysis Methods ; Risk factors ; Sinuses ; Tachycardia ; Thyroid ; Thyroid gland ; Thyroid-stimulating hormone ; Thyrotoxicosis ; Thyroxine</subject><ispartof>PloS one, 2022-09, Vol.17 (9), p.e0273724-e0273724</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Go et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Go et al 2022 Go et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c618t-e459617789672466678c1eabb9015200b3059ceb3bc9779164a58c48e9cab2373</cites><orcidid>0000-0002-1303-7879</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439220/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439220/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids></links><search><creatorcontrib>Go, Muriel Tania</creatorcontrib><creatorcontrib>George, Amrutha Mary</creatorcontrib><creatorcontrib>Tahsin, Bettina</creatorcontrib><creatorcontrib>Fogelfeld, Leon</creatorcontrib><title>Tachycardia in hyperthyroidism: Not so common</title><title>PloS one</title><description>The commonly held association of hyperthyroidism with sinus tachycardia and widened pulse pressure (PP) has not been reassessed in decades despite patients with hyperthyroidism in current practice not always present with these signs. The study objective was to assess prevalence and variability of sinus tachycardia and widened PP in present day among individuals with different degrees of hyperthyroidism. Data was collected retrospectively from 248 adult patients in an outpatient setting with biochemical evidence of hyperthyroidism, recorded heart rate (HR) and blood pressure (BP) who were not treated with medications that can influence these parameters. Mean age was 42.0 ± 14.2 years with 66.9% being female. Median free thyroxine (fT4) level was 3.49 (IQR 2.42-4.58) ng/dL and thyroid stimulating hormone (TSH) 0.02 (IQR 0.01-0.03) mIU/L. Tachycardia, defined as HR >100 bpm, was present in 28.2%. In the lowest and highest fT4 quartiles, tachycardia was present in 16.4% and 38.7% respectively. Using logistic regression, tachycardia was associated with higher fT4 and diastolic BP. More lenient outcome of tachycardia with HR >90 bpm was seen in 47.2%. Widened PP, defined as >50 mmHg, was observed in 64.1% of patients and correlated with higher fT4 and BP. Tachycardia is not a common feature of hyperthyroidism today. The relatively infrequent finding of tachycardia in this study compared to older studies may reflect differences in the way medicine is practiced today. The increased ordering of thyroid function tests most likely unmasked cases of mild or asymptomatic thyrotoxicosis. A widened PP was a more prevalent clinical finding in this study.</description><subject>Age</subject><subject>Antihypertensives</subject><subject>Beta blockers</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac function</subject><subject>Clinical medicine</subject><subject>Clinics</subject><subject>Complications and side effects</subject><subject>Correlation analysis</subject><subject>Development and progression</subject><subject>Gene expression</subject><subject>Heart rate</subject><subject>Hormones</subject><subject>Hypertension</subject><subject>Hyperthyroidism</subject><subject>Medicine and Health Sciences</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Quartiles</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Risk 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Go, Muriel Tania</au><au>George, Amrutha Mary</au><au>Tahsin, Bettina</au><au>Fogelfeld, Leon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tachycardia in hyperthyroidism: Not so common</atitle><jtitle>PloS one</jtitle><date>2022-09-02</date><risdate>2022</risdate><volume>17</volume><issue>9</issue><spage>e0273724</spage><epage>e0273724</epage><pages>e0273724-e0273724</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The commonly held association of hyperthyroidism with sinus tachycardia and widened pulse pressure (PP) has not been reassessed in decades despite patients with hyperthyroidism in current practice not always present with these signs. The study objective was to assess prevalence and variability of sinus tachycardia and widened PP in present day among individuals with different degrees of hyperthyroidism. Data was collected retrospectively from 248 adult patients in an outpatient setting with biochemical evidence of hyperthyroidism, recorded heart rate (HR) and blood pressure (BP) who were not treated with medications that can influence these parameters. Mean age was 42.0 ± 14.2 years with 66.9% being female. Median free thyroxine (fT4) level was 3.49 (IQR 2.42-4.58) ng/dL and thyroid stimulating hormone (TSH) 0.02 (IQR 0.01-0.03) mIU/L. Tachycardia, defined as HR >100 bpm, was present in 28.2%. In the lowest and highest fT4 quartiles, tachycardia was present in 16.4% and 38.7% respectively. Using logistic regression, tachycardia was associated with higher fT4 and diastolic BP. More lenient outcome of tachycardia with HR >90 bpm was seen in 47.2%. Widened PP, defined as >50 mmHg, was observed in 64.1% of patients and correlated with higher fT4 and BP. Tachycardia is not a common feature of hyperthyroidism today. The relatively infrequent finding of tachycardia in this study compared to older studies may reflect differences in the way medicine is practiced today. The increased ordering of thyroid function tests most likely unmasked cases of mild or asymptomatic thyrotoxicosis. A widened PP was a more prevalent clinical finding in this study.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>36054093</pmid><doi>10.1371/journal.pone.0273724</doi><tpages>e0273724</tpages><orcidid>https://orcid.org/0000-0002-1303-7879</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Antihypertensives Beta blockers Biology and Life Sciences Blood pressure Cardiac arrhythmia Cardiac function Clinical medicine Clinics Complications and side effects Correlation analysis Development and progression Gene expression Heart rate Hormones Hypertension Hyperthyroidism Medicine and Health Sciences Patients Physical Sciences Quartiles Regression analysis Research and Analysis Methods Risk factors Sinuses Tachycardia Thyroid Thyroid gland Thyroid-stimulating hormone Thyrotoxicosis Thyroxine |
| title | Tachycardia in hyperthyroidism: Not so common |
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