Hypothyroidism and hyperthyroidism, both overt and subclinical, are associated with increased risk of cardiovascular morbidity and mortality. The association between thyroid-stimulating hormone levels and cardiovascular risk has been demonstrated in large epidemiological studies and meta-analyses and is now considered a U-shaped curve. Several pathophysiological mechanisms linking thyroid and cardiovascular disease are known; however, specific clinical complications of peripheral arterial disease as endpoints of clinical trials have not been adequately investigated. The potential mechanisms linking hypothyroidism and peripheral arterial disease are endothelial dysfunction, blood pressure changes, dyslipidemia, and low-grade systemic inflammation. The potential mechanisms linking hyperthyroidism and peripheral arterial disease are hyperdynamic circulation, elevated systolic blood pressure, hypercoagulability, and possibly increased arterial inflammation.

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甲状腺疾病和周围动脉疾病

甲状腺功能减退症和甲状腺功能亢进症，无论是明显的还是亚临床的，都与心血管发病率和死亡率的风险增加有关。促甲状腺激素水平与心血管风险之间的关联已在大型流行病学研究和荟萃分析中得到证实，目前被认为是 U 形曲线。甲状腺和心血管疾病之间的几种病理生理学机制是已知的；然而，作为临床试验终点的外周动脉疾病的具体临床并发症尚未得到充分研究。甲状腺功能减退症和外周动脉疾病之间的潜在联系机制是内皮功能障碍、血压变化、血脂异常和低度全身炎症。甲状腺功能亢进和外周动脉疾病之间的潜在机制是高动力循环、收缩压升高、高凝状态以及可能增加的动脉炎症。