Cardiovascular risk in autoimmune thyroid diseases according to functional clinical presentation: literature review

Bulgarian Medical Journal, 2025, 19(3), 7-13.

S. Nacheva^{1, 2}, M. Orbetsova^{1, 2}

¹ Clinic of Endocrinology and Metabolic Diseases, University Hospital “Sveti Georgi” – Plovdiv
² Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University – Plovdiv

Abstract. In recent years, autoimmune diseases (AID) have been categorized as diseases of civilization. The most common organ-specific autoimmune disease is autoimmune thyroid disease (AITD). The spectrum of AITD mainly includes Graves-Basedow disease (GB) and Hashimoto’s thyroiditis (TH), with two extremes of clinical presentation – hyperthyroidism and hypothyroidism. Thyroid hormones play an important role in human homeostasis, including maintaining the normal functioning of the cardiovascular system. Cardiovascular disease (CVD) is the leading cause of death worldwide. In different clinical scenarios with abnormal thyroid hormone levels, the cardiovascular system is affected differently. Both hypothyroidism and hyperthyroidism are associated with increased cardiovascular risk. This is of paramount importance for the team approach of doctors in order to build an optimal diagnostic and therapeutic plan. However, the effects of euthyroid autoimmunity on the vascular system have not yet been sufficiently studied. The aim of this literature review is to present the molecular mechanisms involved in the pathogenesis of hemodynamic disorders in clinically and subclinically manifested forms of hypo- and hyperthyroidism, to summarize the known association and frequency between autoimmune thyroid dysfunction and cardiovascular abnormalities. For this purpose, a systematic review of the available scientific literature and electronic searches in PubMed, EBSCO and Google Scholar was conducted.

Key words: autoimmune thyroid diseases, Hashimoto’s thyroiditis, Graves-Basedow disease, cardiovascular risk

Address for correspondence: Dr. Spaska A. Nacheva, Clinic of Endocrinology and Metabolic Diseases, University Hospital “Sveti Georgi”, Medical University, 15A V. Aprilov Blvd., Bg – 4000 Plovdiv, e-mail: spaska.nacheva@mail.bg