Skip to main content

MINI REVIEW article

Front. Cardiovasc. Med.

Sec. Atherosclerosis and Vascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1527271

This article is part of the Research Topic Immunity, Atherosclerosis and Cardiovascular Disease: An Interdisciplinary Approach to Cardiometabolic Health View all 11 articles

Research Status of Subclinical Hypothyroidism Promoting the Development and Progression of Cardiovascular Diseases

Provisionally accepted
  • 1 Shanxi Medical University, Taiyuan, China
  • 2 Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
  • 3 Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China

The final, formatted version of the article will be published soon.

    In recent years, the incidence of cardiovascular disease (CVD) has risen steadily, significantly impacting public health. Subclinical hypothyroidism (SCH) remains a controversial risk factor for CVD. This review examines the associations between SCH and dyslipidemia, carotid intima-media thickness (C-IMT), cardiac dysfunction, and cardiovascular event risk. Evidence suggests SCH may exacerbate atherosclerosis and cardiac dysfunction through mechanisms such as increased LDL synthesis, oxidative stress, and impaired vascular endothelial function. However, the causal link between SCH and cardiovascular outcomes remains unclear due to study design heterogeneity and overreliance on TSH levels. Elevated TSH may not solely reflect thyroid dysfunction but could also indicate compensatory responses to inflammation, aging, or stress. Large-scale studies like NHANES and IPD meta-analyses show a strong association between SCH and cardiovascular risk in younger populations, which diminishes in older adults due to physiological TSH increases. The cardiovascular benefits of levothyroxine (L-T4) therapy in SCH patients are limited, especially in older individuals, where a narrow therapeutic window increases side effect risks. Studies relying solely on TSH as a diagnostic and therapeutic target have significant limitations, as TSH cannot distinguish adaptive thyroid adjustments from pathological states and overlooks the role of free thyroid hormones (FT3/FT4). Future research should integrate multi-dimensional markers (such as oxidative stress indicators, vascular elasticity measures, and thyroid antibody status) and adopt longitudinal study designs to more accurately assess the clinical significance of SCH.

    Keywords: subclinical hypothyroidism1, Cardiovascular disease2, lipid disorders3, atherosclerosis4, diastolic heart function5, levothyroxine6, TSH7

    Received: 13 Nov 2024; Accepted: 24 Mar 2025.

    Copyright: © 2025 Wang, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Haiyan Liu, Shanxi Medical University, Taiyuan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

    Research integrity at Frontiers

    Man ultramarathon runner in the mountains he trains at sunset

    95% of researchers rate our articles as excellent or good

    Learn more about the work of our research integrity team to safeguard the quality of each article we publish.


    Find out more