Abstract
Objective: This is a quality assurance project to assess if hypo- and hyperthyroidism are appropriately screened for in patients with resistant hypertension.
Design: Patient data was collected from patients diagnosed with resistant hypertension, defined as being on four or more different classes of anti-hypertensive medications. These patients were filtered to determine if thyroid stimulating hormone (TSH) screening occurred within 90 days of the addition of a fourth medication class.
Setting: Two internal medicine residency clinics in Pittsburgh, PA.
Participants: Patients were selected who had a diagnosis of hypertension and were seen in clinic between January 1, 2018 to December 23, 2020.
Methods: A single center retrospective review was performed.
Results: A total of 1,125 patients were identified as having resistant hypertension. Of these, only 74 patients were found to have a TSH within 90 days of having a fourth medication class prescribed. Seven TSH values were found to be abnormal with one patient being diagnosed with hyperthyroidism, demonstrating a screening rate of 6.6%. There were statistically significant differences in age, body mass index, and diastolic blood pressure in those screened versus not.
Conclusions: Thyroid disease is under-screened as an etiology for resistant hypertension, particularly given the ease of diagnosis and reversibility of these conditions.
Footnotes
Disclosures: The authors do not have any conflicts of interest or financial support related to this work to disclose.
Authors’ contributions: N.P. and M.T.U.D. drafted and revised original manuscript. P.W. collected the data and performed satistical analyses. D.V. and S.F. revised and final draft of manuscript. All authors give consent to publish.
- Received March 15, 2021.
- Revision received July 17, 2021.
- Revision received August 3, 2021.
- Accepted September 20, 2021.
