What is the current evidence regarding the association between subclinical thyroid dysfunction and cardiovascular disease, and what are the recommendations for screening and treatment?
Thyroid, a prospective cohort study (Eur Heart J 2018, PMID 28329380) — subclinical hyperthyroidism (SHyper) is associated with increased risk of atrial fibrillation (AF) (HR 1.68) and CHD events (HR 1.21). The TSH threshold for initiating treatment is unclear due to the absence of large randomized controlled trials.
Source: Eur Heart J 2018, PMID 28329380 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Eur Heart J · 2018 · PMID 28329380 · DOI 10.1093/eurheartj/ehx050
Subclinical thyroid dysfunction is linked to increased cardiovascular risks, with treatment and screening guidelines varying but generally recommending intervention for significant TSH deviations and screening for at-risk populations.
The question
What is the current evidence regarding the association between subclinical thyroid dysfunction and cardiovascular disease, and what are the recommendations for screening and treatment?
What they tested
The review aims to update current evidence on the association between thyroid dysfunction and cardiovascular disease, as well as on screening and treatment of subclinical thyroid dysfunction.
How they did it
This review summarizes evidence from individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration and other small studies.
What they found
Subclinical hypothyroidism (SHypo) is associated with increased coronary heart disease (CHD) mortality (HR 1.58 for TSH ">=" 10 mIU/L), increased risk of stroke, and heart failure (HF). SHypo also affects carotid intima media thickness (CIMT), diastolic function, peripheral vascular resistance, endothelial function, and lipid profile. Subclinical hyperthyroidism (SHyper) is associated with increased risk of atrial fibrillation (AF) (HR 1.68) and CHD events (HR 1.21).
| SHypo (TSH ">= 10 mIU/L) CHD Mortality HR | 1.58 | |
|---|---|---|
| SHyper AF Risk HR | 1.68 | |
| SHyper CHD Events HR | 1.21 |
Hazard ratios for cardiovascular outcomes associated with subclinical thyroid dysfunction.
What it means
Subclinical thyroid dysfunction is associated with various cardiovascular risks. Treatment for SHypo is suggested at TSH ">=" 10 mIU/L, and for SHyper at TSH "<" 0.1 mIU/L. Screening is advocated for individuals at risk for hypothyroidism, those over 60, and those with known CHD and HF.
Limitations
The TSH threshold for initiating treatment is unclear due to the absence of large randomized controlled trials. Recommendations on screening are discordant.
The paper at a glance
| Magellan’s evidence label | TSH and thyroid function (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Eur Heart J |
| Year | 2018 |
| PMID | 28329380 ↗ |
| DOI | 10.1093/eurheartj/ehx050 ↗ |
| Topic | Cardiovascular & vascular aging |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.
Thyroid (TSH) Home Panel
Subclinical dysfunction raises coronary mortality. Research relevant to this mechanism is indexed on PubMed and linked below; it describes the mechanism rather than this specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the current evidence regarding the association between subclinical thyroid dysfunction and cardiovascular disease, and what are the recommendations for screening and treatment? [Plain-English summary of Eur Heart J 2018, PMID 28329380, DOI 10.1093/eurheartj/ehx050]. Magellan Longevity. https://magellanlongevity.com/study/s148.html@misc{magellan_s148,
title = {What is the current evidence regarding the association between subclinical thyroid dysfunction and cardiovascular disease, and what are the recommendations for screening and treatment?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s148.html}},
note = {Plain-English summary of PubMed PMID 28329380; DOI 10.1093/eurheartj/ehx050; Eur Heart J 2018. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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