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Editor - There is a need to emphasise a statement by Price and
Weetman in their important letter entitled "Thyroid stimulating hormone
outside the normal range has important implications". They couple changes
in endothelial function and cholesterol concentrations in subclinical
hypothyroidism (1). They refer to the Rotterdam Study (2) but the
Rotterdam workers showed that the risk factor for coronary heart disease
was independent and not related to hypercholesterolaemia. Changes in the
endothelial function in subclinical hypothyroidism leads to a decreased
blood flow which is the probable cause of the atheroma in their subjects
(3). It was Professor Toft and his colleagues who first showed that left
ventricular performance was impaired in subclinical hypothyroidism (4).
Dr P B S Fowler
152, HARLEY STREET,
LONDON,
W1NN 1HH
Ref:
1. Price A, Weetman AP. Thyroid stimulating hormone outside the
normal range has important implications. BMJ 2000;321:1080 (28 October
00)
2. Hak EA, Pols HAP, Visser TJ, Drexhage HA, Hofman W, Jacqueline CM.
Subclinical hypothyroidism is an independent risk factor for
atherosclerosis and myocardial infarction in elderly women: the Rotterdam
study. Ann Intern Med 2000;131:270-8
3. Fowler PBS. The thyroid, blood flow and atheroma. Q J Med
2000;93:477-485
4. Forfar JC, Wathen CG, Todd WTA, Bell GM, Hannan WJ, Muir AL, Toft
AD. Left ventricular performance in subclinical hypothyroidism. Q J Med
1985;57:857-65
Thyroid function tests
Editor - There is a need to emphasise a statement by Price and
Weetman in their important letter entitled "Thyroid stimulating hormone
outside the normal range has important implications". They couple changes
in endothelial function and cholesterol concentrations in subclinical
hypothyroidism (1). They refer to the Rotterdam Study (2) but the
Rotterdam workers showed that the risk factor for coronary heart disease
was independent and not related to hypercholesterolaemia. Changes in the
endothelial function in subclinical hypothyroidism leads to a decreased
blood flow which is the probable cause of the atheroma in their subjects
(3). It was Professor Toft and his colleagues who first showed that left
ventricular performance was impaired in subclinical hypothyroidism (4).
Dr P B S Fowler
152, HARLEY STREET,
LONDON,
W1NN 1HH
Ref:
1. Price A, Weetman AP. Thyroid stimulating hormone outside the
normal range has important implications. BMJ 2000;321:1080 (28 October
00)
2. Hak EA, Pols HAP, Visser TJ, Drexhage HA, Hofman W, Jacqueline CM.
Subclinical hypothyroidism is an independent risk factor for
atherosclerosis and myocardial infarction in elderly women: the Rotterdam
study. Ann Intern Med 2000;131:270-8
3. Fowler PBS. The thyroid, blood flow and atheroma. Q J Med
2000;93:477-485
4. Forfar JC, Wathen CG, Todd WTA, Bell GM, Hannan WJ, Muir AL, Toft
AD. Left ventricular performance in subclinical hypothyroidism. Q J Med
1985;57:857-65
Competing interests: No competing interests