Hypothyroidism and Hypertension

Hypothyroidism, commonly referred to as underactive thyroid, is a situation where the thyroid gland struggles to produce enough hormone. This deficiency slows metabolism and heart rate, creates digestive problems and prompts weight gain. It can even lead to hypertension or high blood pressure. 

Hypertension is a condition where the artery walls experience excessive force of blood, which ultimately damages the arteries. While the occasional spike in blood pressure is normal, persistent high blood pressure increases the risk of life-threatening conditions like a heart attack.

Now, hypertension and hypothyroidism are related to each other. Since hypothyroidism reduces heart rates, it creates hurdles for the blood vessels and slowly raises the blood pressure.

Pathophysiology

Thyroid hormones help to keep the heart and blood vessels healthy. When hypothyroidism occurs, the thyroid gland doesn't produce enough hormones. Thus, the heart rates become slow, which also reduces the flexibility in blood vessels. So, the heart faces difficulty in pumping the blood across the body, and consequently, the blood pressure rises.

The impact of hormonal imbalance, or hypothyroidism in this case, is not limited to increased blood pressure. It also increases cholesterol levels. The thyroid hormones help remove bad cholesterol from the blood, so a lack of hormones means that bad cholesterol deposits in the arteries. Hence, the risk of stroke and other heart diseases increases significantly. 

Risk Factors

The risk factors associated here are –

Genetic Predispositions

Genetic mutations such as atherosclerotic changes cause high blood pressure. It occurs in the hypothalamus-pituitary-thyroid axis and has cardiovascular consequences like thyroid dysfunction and lipid abnormalities. 
Moreover, both diseases can arise if there is a family history of these. Specifically, individuals inherit these diseases from their parents. 

Lifestyle Factors

• Excessive amounts of carbohydrates and fat intake can lead to hypothyroidism. These foods increase cholesterol levels, too. It also results in hypertension. 
• Insufficient sleep extends the risk of hypertension. Moreover, sleeping disorders affect the level of thyroid hormones. 
• Specific medications and supplements increase the risk of high blood pressure and hypothyroidism.
• Moreover, stress can contribute to both conditions.

Age and Gender Considerations

• The possibility of hypothyroidism is high in individuals of more than 60 years old. Women have 5 to 8 times more chances of hypothyroidism than men.
• In the case of hypertension, males have more chances of becoming diseased than females. Numerous studies have proved that males younger than 65 years have consistently greater hypertension than females of the same age. 

Symptoms

Diagnosis

The diagnosis process of hypothyroidism and hypertension includes the following –

Testing for Thyroid Function

• Thyroid Function Test (TFT): Measure T4, T3, and TSH levels.
• Thyroid antibodies test: Help to identify if there is any autoimmune thyroid condition such as Hashimoto's disease. 

Monitoring and Measuring Blood Pressure

Blood pressure monitoring at home: The measurement occurs with a cuff around the upper arm. It guides the healthcare providers to understand if the medications are working well. 

• Lab tests: In this case, the blood and urine are tested. It becomes helpful in severe high blood pressure. 
• Ambulatory monitoring: It's a longer process of blood pressure monitoring in regular intervals over 6 or 24 hours. 

Diagnosing Concomitant Conditions

Besides evaluating each condition separately, the doctors will also keep an eye out for the concomitant conditions. They check patients for symptoms like fatigue, weight gain, cold intolerance and, most importantly, elevated blood pressure. Now, based on this evaluation, the doctors suggest more clinical tests to establish the extent of the disease and then start the treatment. 

Management and Treatment

The management and treatment of these two conditions will include the following –

Medications for Hypothyroidism

• Levothyroxine
• Liothyronine
• Adthyza 

Managing Hypertension

• ACE inhibitors (lisinopril and enalapril): Improve the flexibility of blood vessels and protect the kidney. 
• Calcium channel blockers (felodipine and amlodipine): Enhance flexibility of blood vessels.
• Diuretics (chlorthalidone and hydrochlorothiazide): Reduce blood pressure by eliminating excessive water from the body. 

Integrative Approach for Coexisting Conditions

• Individuals should take the prescribed medications for both conditions.
• Regular monitoring and check-ups by the doctor are vital for understanding blood pressure and thyroid hormone levels.
• To reduce stress, patients should engage in physical activities such as yoga, meditation, deep breathing, walking, etc.
• They should maintain a nutrient-rich, balanced diet. 

Lifestyle and Dietary Recommendations

DASH (Dietary Approaches to Stop Hypertension) diets are good for hypertension and help manage thyroid health. The diet includes fruits, whole grains, fish, vegetables, poultry, low-fat dairy products, etc. Here is more on the same –

Thyroid-Friendly Diet

Eat foods containing iodine, selenium, and zinc. 

• Also, hypothyroidism causes deficiency in vitamin B12, vitamin D, Iron, and magnesium. Thus, individuals should eat foods that have these nutrients.
• Avoid fast foods and foods with gluten and goitrogens. 
• Eat fresh vegetables (both starch and non-starchy) and fruits. 

Heart-Healthy Dietary Habits

• Eat nutrient-rich and low-calorie foods like vegetables and fruits.
• Try to take whole grains such as wheat flour, oatmeal, etc. 
• Prefer low-fat proteins like eggs, fish, legumes, etc.  
• Avoid salty foods (stay under 2 grams/day).

Importance of Regular Physical Activity

Physical activities stimulate the production of hormones that help to improve hypothyroidism symptoms. Also, moderate levels of exercise, such as walking, cycling, etc., can reduce stress, strengthen heart functions, and lower blood pressure. 

Complications

Some of the complications associated with the combination of these two conditions include –

Cardiovascular Complications

• Heart attack: Blood supply to the heart gets choked, and heart muscle cells are demolished due to lack of oxygen.
• Irregular heartbeat: It can cause sudden death.
• Heart failure: The heart can't pump sufficient blood, and the other organs don't get oxygen. 

Metabolic and Endocrine Implications

• Myxedema coma: It's a life-threatening complication of hypothyroidism that occurs due to physical stress, specific medication or injury. Generally, it happens in patients who have a long history of hypothyroidism. 
• Metabolic complications: These include symptoms such as cold intolerance, hypothermia, and weight gain. 

Prevention Strategies

Some of the prevention strategies for these two conditions include –

Monitoring Thyroid Levels

Thyroid levels monitoring include -

• TSH or thyroid stimulating hormone test 
• T4 or thyroxine test
• T3 or triiodothyronine test

Regular Blood Pressure Check-Ups

• Systolic pressure: The upper number of measurements of the pressure in arteries when the heart beats.
• Diastolic pressure: The lower number of measurements of the pressure in arteries between the heartbeats. 

Early Detection and Treatment of Symptoms

Severe hypothyroidism leads to goitre, heart disease, mental issues, infertility, etc. Thus, early detection and treatment are necessary to eliminate these risks. The treatment includes -

• Take medications regularly
• Take iodine-rich foods and maintain a balanced diet
• Engage in physical exercise
• Drink plenty of water
• Take adequate sleep and rest

Early detection of hypertension can protect patients from life risks such as stroke, heart failure, and irregular heartbeat. General hypertension treatments are -

• Weight loss
• Low salt and healthy diet
• Engage in physical activity
• Taking medications
• No Tobacco 

Conclusion

Hypothyroidism and hypertension are connected to each other, and one can worsen the other condition significantly. To be more precise, the aftermath of hypothyroidism, which is reduced metabolism and heart rate, is the fundamental cause of hypertension.

So, considering their interrelation, opting for a coordinated treatment plan is important. Here, the doctors perform needed tests and check-ups and then address each condition as its own, which ultimately helps the patients get better. Having said that, physicians always emphasise preventive measures to ensure that these conditions don’t develop in the first place. 

So, individuals can take cues from this write-up and focus on living an active lifestyle and following a healthy diet to avoid becoming a victim of hypothyroidism and hypertension.