Evaluating The Relationship Between Thyroid Dysfunction And Cardiovascular Diseases: A Systematic Review
Bibliographic record
Abstract
Background: Thyroid hormones play a critical role in regulating cardiovascular physiology. Dysregulation, whether overt or subclinical, has been linked to arrhythmias, heart failure, atherosclerosis, and metabolic disturbances. Understanding these associations is crucial for early risk stratification and clinical intervention. Objective: To systematically review observational and Mendelian randomization studies examining the relationship between thyroid dysfunction and cardiovascular diseases (CVDs). Methods: Following PRISMA 2020 guidelines, electronic databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar were searched for studies published between 2016 and 2025. Studies assessing serum thyroid hormones (TSH, FT3, FT4), subclinical or overt thyroid disease, or genetically predicted thyroid function and cardiovascular outcomes were included. Both cross-sectional, cohort, and Mendelian randomization designs were considered. Data extraction focused on sample characteristics, thyroid measures, cardiovascular outcomes, and effect estimates. Quality was assessed using the Newcastle–Ottawa Scale and MR-specific criteria. Results: Ten studies were included, encompassing >1.5 million participants across global cohorts. Low thyroid function correlated with adverse cardiovascular health metrics and metabolic risk factors (Fang et al., 2024; Bai et al., 2025; Neves et al., 2022). Hyperthyroid tendencies, indicated by low TSH or high FT4, were causally linked to atrial fibrillation (Larsson et al., 2019; Ellervik et al., 2019). MR analyses showed protective effects of mild hypothyroidism against stroke (Marouli et al., 2020) but no consistent relationship with ischemic heart disease (Zhao & Schooling, 2017). Hormone replacement therapy required careful titration to avoid over- or under-replacement, impacting cardiovascular outcomes (Evron et al., 2022; Stamatouli et al., 2020). Conclusions: Thyroid dysfunction, including subclinical states, has significant implications for cardiovascular health. Both metabolic and arrhythmic pathways mediate this risk, emphasizing the need for early detection, individualized monitoring, and multidisciplinary management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".