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Systematic review
In people with subclinical hypothyroidism, TSH level >10 mIU/l may predict increased risk of coronary heart disease and related mortality
  1. Elizabeth N Pearce
  1. Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Elizabeth N Pearce
    88 East Newton Street, Evans 201, Boston, MA 02118, USA; Elizabeth.pearce{at}bmc.org

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Context

Subclinical hypothyroidism, defined as an elevated thyroid-stimulating hormone (TSH) level with normal peripheral free thyroid hormone values, is highly prevalent, occurring in 4–10% of adults.1 Observational studies have identified associations between subclinical hypothyroidism and hyperlipidaemia and other atherosclerosis risk factors. However, it has been unclear whether subclinical hypothyroidism is associated with an increased risk for cardiovascular events and mortality. Results of several longitudinal studies and three previous study-level meta-analyses2,,4 have been inconsistent. Individual-level meta-analyses had not previously been performed.

Methods

Rodondi and colleagues used a systematic literature search in all languages to identify potential studies for inclusion in a meta-analysis. MEDLINE and EMBASE databases and searches of key article bibliographies were used to identify articles describing associations between subclinical thyroid …

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