To the Editor: Dr Rodondi and colleagues1 assessed the risk of CHD and total mortality for adults with subclinical hypothyroidism. In this study, the hazard ratio (HR) for CHD events was 1.00 (95% confidence interval [CI], 0.86-1.18) for a TSH level of 4.5 to 6.9 mIU/L, 1.17 (95% CI, 0.96-1.43) for a TSH level of 7.0 to 9.9 mIU/L, and 1.89 (95% CI, 1.28-2.80) for a TSH level of 10.0 to 19.9 mIU/L. They concluded that subclinical hypothyroidism was associated with an increased risk of CHD events and CHD mortality in persons with higher TSH levels, particularly in those with a TSH concentration of 10 mIU/L or greater, and that minimal TSH elevations were not associated with an increased risk of CHD events and CHD mortality. However, they did not verify the CHD events and CHD mortality among those within the reference range of TSH levels.
Takamura N, Hayashida N, Maeda T. Risk of Coronary Heart Disease and Mortality for Adults With Subclinical Hypothyroidism. JAMA. 2010;304(22):2481-2482. doi:10.1001/jama.2010.1787