European Journal of Cardiovascular Medicine

Background: Hypothyroidism is common and influences the heart and vessels by altering myocardial performance, systemic vascular tone, and lipid handling. Cardiovascular abnormalities, if undetected, may predispose patients to long-term morbidity, though many are reversible with timely thyroid hormone therapy. Objectives: To evaluate the spectrum of cardiovascular manifestations in hypothyroid patients and to assess the associations of thyroid dysfunction with clinical, biochemical, and echocardiographic parameters. Methods: A hospital-based cross-sectional study was conducted over one year at the Department of General Medicine, Sri Venkateswara Medical College, Tirupati. Ninety adult hypothyroid patients (≥18 years) were enrolled. Clinical examination, ECG, echocardiography, and biochemical tests including thyroid profile and lipid parameters were performed. Data were analyzed using SPSS v25, with Mann–Whitney U test, Kruskal–Walli’s test, correlation, and regression analysis applied where appropriate. Results: The study population was predominantly female (93.3%), with a mean age of 31.3 years. Most participants had normal ECG (96.7%) and echocardiography (88.9%) findings, though a minority showed sinus tachycardia (3.3%), dilated cardiomyopathy (3.3%), concentric LVH (2.2%), and moderate aortic stenosis (3.3%). Dyslipidemia was common, with wide variation in triglycerides (mean 161.8 ± 89.7 mg/dl). Significant sex-based differences were observed in systolic BP, PPBS, T3, T4, LDL, creatinine, and calcium. Age group analysis revealed significant variation in PPBS, TSH, HDL, LDL, and calcium. Correlation analysis showed strong associations between age, thyroid profile, glucose, and lipid parameters. Regression analysis identified age as an independent predictor of total cholesterol (p=0.001), while thyroid hormone levels were not. Conclusion: Hypothyroidism is associated with subtle but clinically relevant cardiovascular manifestations, including dyslipidemia, metabolic disturbances, and occasional structural heart abnormalities. Female predominance was reaffirmed, and age emerged as an independent predictor of cholesterol levels. These findings highlight the importance of routine cardiovascular evaluation in hypothyroid patients for early detection and prevention of long-term complications.