Indian journal of endocrinology and metabolism
May 1, 2026 · via Europe PMC
Revisiting the Thyroid-Heart Axis: Unravelling the Interplay of Hormones, Epigenomes and Precision Cardioprotection.
Parveen N, Chittawar S, Khandelwal D, Aggarwal S.
AI summary — for doctors, generated from the abstract only
This review explains how aging changes the way thyroid hormones affect the heart, making older adults with even mild thyroid dysfunction more vulnerable to cardiovascular problems, and proposes tissue-targeted thyroid hormone therapy as a future precision medicine strategy.
What was studied
A narrative review (not a primary study) discussing the relationship between thyroid dysfunction and cardiovascular disease in older adults, covering how aging alters thyroid hormone receptor sensitivity, enzyme activity, and epigenetic regulation, leading to tissue-specific thyroid hormone insufficiency despite normal blood test results, and the roles of subclinical hypothyroidism and low-T3 syndrome.
Key findings
- Subclinical hypothyroidism and low-T3 syndrome are described as especially prevalent in older adults and linked to higher risks of heart failure, atherosclerosis, atrial fibrillation, and mortality.
- Aging is described as altering thyroid hormone receptor sensitivity, deiodinase enzyme activity, and epigenetic control, which can cause tissue-specific thyroid hormone insufficiency even when standard blood tests appear normal.
- The review discusses emerging roles for epigenetic regulators and a proposed gut-thyroid-heart axis in modulating cardiovascular responses to thyroid hormone imbalance.
- The review proposes tissue-selective thyroid hormone-based therapies as a promising future approach for precision cardioprotection in this population.
Clinical relevance
This review suggests that routine thyroid function assessment is important in patients with cardiovascular disease, particularly older adults, and that management should be tailored to age-related cardiovascular risk, since standard thyroid blood tests may not fully capture tissue-level thyroid hormone insufficiency relevant to heart health.
Who should care
Limitations
As a narrative review, it synthesizes existing mechanistic and epidemiological evidence rather than presenting new primary data; proposed concepts like tissue-selective thyroid hormone therapy and the gut-thyroid-heart axis remain largely investigational.
Even mild thyroid hormone imbalance may meaningfully affect heart health in older adults due to age-related changes in how the body uses thyroid hormone, supporting routine thyroid screening in cardiovascular patients and pointing toward future targeted therapies.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Thyroid dysfunction (TD) and cardiovascular disease (CVD) commonly coexist in older adults, where age-related vascular, mitochondrial, and autonomic changes heighten sensitivity to even mild hormonal imbalance. Thyroid hormones (THs) regulate cardiac and vascular function through genomic and non-genomic pathways, but aging alters receptor sensitivity, deiodinase (DIO) activity, and epigenetic control, resulting in tissue-specific TH insufficiency despite normal serum levels. Subclinical hypothyroidism (SCH) and low-T3 syndrome are especially prevalent in older adults and are linked to higher risks of heart failure (HF), atherosclerosis, atrial fibrillation, and mortality. Emerging data underscore the role of epigenetic regulators and the gut-thyroid-heart axis in modulating CV responses to TH imbalance. Clinically, routine thyroid function assessment is crucial in CVD, with management tailored to age-related risks. Tissue-selective TH based therapies represent a promising frontier for precision cardioprotection.
Thyroid dysfunction (TD) and cardiovascular disease (CVD) commonly coexist in older adults, where age-related vascular, mitochondrial, and autonomic changes heighten sensitivity to even mild hormonal imbalance. Thyroid hormones (THs) regulate cardiac and vascular function through genomic and non-genomic pathways, but aging alters receptor sensitivity, deiodinase (DIO) activity, and epigenetic control, resulting in tissue-specific TH insufficiency despite normal serum levels. Subclinical hypothyroidism (SCH) and low-T3 syndrome are especially prevalent in older adults and are linked to higher risks of heart failure (HF), atherosclerosis, atrial fibrillation, and mortality. Emerging data underscore the role of epigenetic regulators and the gut-thyroid-heart axis in modulating CV responses to TH imbalance. Clinically, routine thyroid function assessment is crucial in CVD, with management tailored to age-related risks. Tissue-selective TH based therapies represent a promising frontier for precision cardioprotection.
DOI
10.4103/ijem.ijem_24_26
PMID
42540973
PMCID
PMC13427014
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed