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2026, Vol: 10, Issue: 7
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Review Article
Online Published: 18 Jun 2026
 


Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis

Tameem Abdulaziz Alhomaid, Mohammed N. Aljabr, Ziyad M. Alsughayyir, Ahmad K. Alanazi, Eyad K. Alharbi, Yousef J. Aldaher, Nasser A. Aljarboa, Mohammed I. Alahmadi, Abdullah R. Alradhi.


Abstract
Subclinical hypothyroidism (SCH) is prevalent in adults and has been implicated in adverse cardiovascular outcomes through mechanisms encompassing endothelial dysfunction, dyslipidaemia, and impaired myocardial contractility. However, the extent to which cardiovascular risk varies by thyroid-stimulating hormone (TSH) severity, age, and clinical context remains uncertain. A systematic review and meta-analysis were conducted. Eligible studies compared cardiovascular outcomes in adults with SCH versus euthyroid controls and reported adjusted effect estimates. Random-effects models were used to pool hazard ratios (HRs). Stratified analyses were performed by TSH threshold (<10 vs. ≥10 mIU/l), age (<65 vs. ≥65 years), and clinical setting. Seven studies involving community-based cohorts, individual participant data meta-analyses, and PCI-treated populations were included. SCH was associated with increased all-cause mortality (pooled HR 1.42, 95% CI 1.08-1.86; I² = 31%) and cardiovascular mortality (pooled HR 1.58, 95% CI 1.13-2.19; I² = 0%). Coronary heart disease (CHD) events and CHD mortality were significantly elevated primarily at TSH ≥10 mIU/l. In patients presenting with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI), previously unrecognized SCH was associated with acute kidney injury, reduced left ventricular ejection fraction, and more than twofold higher long-term mortality. On the contrary, no significant mortality association was observed among elderly patients undergoing elective PCI. Age-stratified analyses demonstrated lower cardiovascular risk in adults ≥65 years than in younger adults. SCH carries a clinically meaningful cardiovascular mortality burden. The findings support TSH-stratified risk assessment, routine thyroid screening in acute coronary presentations, and dedicated interventional trials in younger, higher-risk populations.

Key words: Subclinical hypothyroidism, cardiovascular mortality, coronary heart disease, percutaneous coronary intervention, TSH threshold, meta-analysis


 
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How to Cite this Article
Pubmed Style

Alhomaid TA, Aljabr MN, Alsughayyir ZM, Alanazi AK, Alharbi EK, Aldaher YJ, Aljarboa NA, Alahmadi MI, Alradhi AR. Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1948-1957. doi:10.24911/IJMDC.51-1772525404

Web Style

Alhomaid TA, Aljabr MN, Alsughayyir ZM, Alanazi AK, Alharbi EK, Aldaher YJ, Aljarboa NA, Alahmadi MI, Alradhi AR. Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. https://www.ijmdc.com/?mno=312484 [Access: July 08, 2026]. doi:10.24911/IJMDC.51-1772525404

AMA (American Medical Association) Style

Alhomaid TA, Aljabr MN, Alsughayyir ZM, Alanazi AK, Alharbi EK, Aldaher YJ, Aljarboa NA, Alahmadi MI, Alradhi AR. Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1948-1957. doi:10.24911/IJMDC.51-1772525404


Vancouver/ICMJE Style

Alhomaid TA, Aljabr MN, Alsughayyir ZM, Alanazi AK, Alharbi EK, Aldaher YJ, Aljarboa NA, Alahmadi MI, Alradhi AR. Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. IJMDC. (2026), [cited July 08, 2026]; 10(7): 1948-1957. doi:10.24911/IJMDC.51-1772525404


Harvard Style

Alhomaid, T. A., Aljabr, . M. N., Alsughayyir, . Z. M., Alanazi, . A. K., Alharbi, . E. K., Aldaher, . Y. J., Aljarboa, . N. A., Alahmadi, . M. I. & Alradhi, . A. R. (2026) Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. IJMDC, 10 (7), 1948-1957. doi:10.24911/IJMDC.51-1772525404


Turabian Style

Alhomaid, Tameem Abdulaziz, Mohammed N. Aljabr, Ziyad M. Alsughayyir, Ahmad K. Alanazi, Eyad K. Alharbi, Yousef J. Aldaher, Nasser A. Aljarboa, Mohammed I. Alahmadi, and Abdullah R. Alradhi. 2026. Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1948-1957. doi:10.24911/IJMDC.51-1772525404


Chicago Style

Alhomaid, Tameem Abdulaziz, Mohammed N. Aljabr, Ziyad M. Alsughayyir, Ahmad K. Alanazi, Eyad K. Alharbi, Yousef J. Aldaher, Nasser A. Aljarboa, Mohammed I. Alahmadi, and Abdullah R. Alradhi. "Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10 (2026), 1948-1957. doi:10.24911/IJMDC.51-1772525404


MLA (The Modern Language Association) Style

Alhomaid, Tameem Abdulaziz, Mohammed N. Aljabr, Ziyad M. Alsughayyir, Ahmad K. Alanazi, Eyad K. Alharbi, Yousef J. Aldaher, Nasser A. Aljarboa, Mohammed I. Alahmadi, and Abdullah R. Alradhi. "Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10.7 (2026), 1948-1957. Print. doi:10.24911/IJMDC.51-1772525404


APA (American Psychological Association) Style

Alhomaid, T. A., Aljabr, . M. N., Alsughayyir, . Z. M., Alanazi, . A. K., Alharbi, . E. K., Aldaher, . Y. J., Aljarboa, . N. A., Alahmadi, . M. I. & Alradhi, . A. R. (2026) Cardiovascular outcomes associated with subclinical hypothyroidism in young adults compared to older adults: a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1948-1957. doi:10.24911/IJMDC.51-1772525404




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