Takayasu arteritis and hyperthyroidism: A secondary hypertension case report.

INTRODUCTION: Renovascular disease and hyperthyroidism are secondary hypertension. Takayasu arteritis (TAK) is a chronic, progressive, nonspecific great vasculitis involving the aorta and its major branches. It is one of the causes of renal artery stenosis. Hyperthyroidism is an endocrine disease caused by improper continuous synthesis and secretion of excessive thyroid hormone by the thyroid gland. Both diseases can raise blood pressure (BP). CASE PRESENTATION: we present a case of 18-year-old. Female, after exercise, fatigue palpitations. The maximum BP was 190/87 mm Hg, ankle-brachial index was <0.9. C-reactive protein and erythrocyte sedimentation rate were elevated. Imaging revealed multiple vascular stenosis. Triiodothyronine, tetraiodothyroxine, serum-free triiodothyronine, serum-free thyroxine, thyroid peroxidase antibody and thyroid stimulating receptor antibody were elevated. TSH reduced. She was diagnosed with TAK and hyperthyroidism. After treatment, the BP was normal, the thyroid function gradually returned to normal, and the symptoms improved. CONCLUSION: It is suggested that the BP of both upper limbs should be measured in newly diagnostic hypertension. If BP is not measured in both upper limbs, it is likely to be missed diagnosis. The cause of vascular stenosis needs to be identified, otherwise interventional treatment may lead to aggravation of the condition. Few cases of TAK complicated with hyperthyroidism have been reported. Both diseases are related to the immune system, whether there is any correlation between the 2 diseases, further research is needed. Early diagnosis, early treatment, the earlier intervention, the better prognosis.

Red cell distribution width and homocysteine act as independent risk factors for cardiovascular events in newly diagnostic essential hypertension.

Hyperhomocysteinemia and increased red cell distribution width (RDW) are associated with a higher possibility of adverse clinical outcomes of hypertension. The study aims to validate the effect of homocysteine (Hcy) and RDW on cardiovascular events (CVE) and investigate whether RDW is independently associated with serum Hcy in patients with essential hypertension (EH). The study reviewed 804 patients with newly diagnosed EH in our hospital. The clinical characteristics and laboratory results of all subjects were grouped according to the presence/absence of CVE. Patients in the CVE group had higher RDW and Hcy, as compared to the patients in the no CVE group. Multiple Cox regression analysis demonstrated that both RDW (HR = 1.24, 95% CI =1.02-1.56, P = 0.002) and Hcy (HR = 1.37, 95% CI = 1.02-1.80, P < 0.001) resulted significantly related to the CVE. Subsequent analysis found that patients with high RDW had higher Hcy levels as compared with those with low RDW (P = 0.007). Although Pearson's correlation suggested that RDW was positively correlated with Hcy (r = 0.122, P = 0.028), no significant correlation was observed between RDW and Hcy (ß = 0.15, p = 0.126) after adjusted for a series of potential confounders using multiple linear regression analysis. In conclusion, RDW is not correlated with Hcy in patients with EH. Both RDW and Hcy are independent risk factors for CVE in newly diagnostic EH and have the potential to improve risk stratification.