THE DEVELOPMENT OF ISCHEMIC-HEART-DISEASE IN RELATION TO AUTOIMMUNE THYROID-DISEASE IN A 20-YEAR FOLLOW-UP-STUDY OF AN ENGLISH COMMUNITY

The original Whickham Survey documented risk factors for cardiovascula r disease and the prevalence of thyroid disorders in a sample of 2779 adults that closely matched the British population. A 20-year follow-u p study has determined outcomes in terms of morbidity and mortality fr om ischemic heart disease in over 97% of the original survey populatio n. Analysis of deaths from all causes and from ischemic heart disease showed no association with antithyroid antibody status identified at f irst survey. A multiple logistic regression using the development of i schemic heart disease in the total population at follow-up as the depe ndent variable found that the significant predictor variables for men were age, cholesterol, mean arterial blood pressure, smoking history, and skinfold thickness index. For women only age, cholesterol, and mea n arterial blood pressure were significant. The presence of autoimmune thyroid disease, as defined by either hypothyroidism, positive antith yroid antibodies, or raised serum thyrotropin at first survey, was not significant. A retrospective cohort study of a subsample of women ide ntified at first survey with positive antithyroid antibodies or raised serum thyrotropin and closely matched controls found no significant a ssociation with mortality or development of ischemic heart disease. Th ere is no evidence from this study to suggest that evidence of autoimm une thyroid disease identified 20 years ago is associated with an incr eased risk of ischemic heart disease.