THYROID AND THE HEART

Coming as I did into medicine with special training in the functioning of the thyroid gland—prior to medical school I took my Ph.D. in physiology, did research on the thyroid for my doctoral dissertation, and taught endocrinology at the University of Chicago—I was prepared to find faulty thyroid functioning capable of producing a wide array of problems.

But I was not prepared particularly for the finding that hypothyroidism could play any significant role in heart problems and that thyroid therapy could offer any protection against "coronaries."

In 1950, however, a friend had a heart attack. He lived at a distance, had not been a patient of mine, but after his attack, when I visited him and went over his history, I found that for some years he had suffered symptoms of hypothyroidism for which he had not sought medical advice.

Suddenly, then, it struck me that in my medical practice, which had attracted a sizeable proportion of patients with thyroid problems who had been treated with thyroid, heart attacks had been conspicuously absent—at a time when they were rising rapidly in the general population.

Was this coincidence? Cholesterol was supposed to be a culprit, a major culprit according to some investigators. The thyroid had much to do with controlling blood cholesterol levels. It seemed to me that the possible role of thyroid deficiency in heart disease needed to be investigated.

Beginning in 1950 each new adult patient, in addition to testing for thyroid function, was questioned about any history of heart disease in the family and received a chest X-ray for heart size, an electrocardiogram and other heart studies. There was no reduction of fats or cholesterol-rich foods in the diet. The only change in daily routine was the taking of thryoid medication for hypothyroidism.

When I had accumulated a sizeable number of patients followed over an extended period of years, I made an analysis. There were 490 women aged thirty to fifty-nine. Based on national statistics, in this many women over the period of time, eight cases of heart disease were to be expected. None had developed.

There were 172 high-risk women—that is, women with high blood pressure or high cholesterol levels or both; in that group of women, based on national statistics, at least seven cases of heart disease were to be expected. None had developed.

There were 182 women aged sixty and over and in that group eight cases were to be expected. None had developed.

There were 382 men, aged thirty to fifty-nine, and, based on national statistics, it was to be expected that at least twelve would develop heart disease. Only one did.

There were 186 high-risk men; nineteen cases of heart disease were to be expected; there were only two.

There were 157 men, aged sixty and over; eighteen cases were to be expected; only one developed.

Thus, with seventy-two cases of heart disease to be expected based on national statistics and with only four actually developing, treatment for hypothyroidism produced 94 percent protection.

*6\269\2*