Hypothyroidism as a Risk Factor for Cardiovascular Disease in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with an increased risk of cardiovascular disease (CVD). The studies report, that hypothyroidism, a common comorbidity in RA, further exacerbates cardiovascular risk through metabolic, inflammatory, and endothelial dysfunction mechanisms. H.G. Raterman et al. showed that, the subclinical hypothyroidism in patients with rheumatoid arthritis had significantly higher CVD risks comparing to euthyroid status. As well as age and gender has a cumulative incident role in it. A significant difference is found between the cohorts in the presence of either hypothyroidism / subclinical hypothyroidism / AITD, at the time of diagnosis. Hypothyroidism leads to bradycardia, reduced cardiac output, and diastolic dysfunction, compounding the risk of heart failure in RA patients. Various studies showed, that the hypothyroidism is associated with the elevated levels of LDL, VLDL, total cholesterol, and triglycerides, with reduced clearance from circulation. The hypercholesterolemia seen in RA patients are further exacerbated by hypothyroidism, promoting atherosclerosis and plaque formation. Some studies demonstrated that he increased prevalence of hypertension and myocardial fibrosis in hypothyroid individuals further exacerbated the cardiovascular burden. This study aims to explore the impact of hypothyroidism on CVD development in RA patients and highlight potential management strategies.