Association between thyroid cysts and hypertension by atherosclerosis status: a cross-sectional study

Our recent studies indicate that thyroid cysts have clinical implications. Thyroid cysts could have a positive effect on the supply of thyroid hormones. Both hyperthyroidism and hypothyroidism cause hypertension. Hypothyroidism, but not hyperthyroidism, is a risk factor for atherosclerosis. Therefore, thyroid cysts could be associated with hypertension, and atherosclerosis might influence the association between thyroid cysts and hypertension. To evaluate the clinical significance of thyroid cysts, a cross-sectional study was conducted with 1801 Japanese aged 40–74 years. Thyroid cysts were significantly positively associated with hypertension in participants without atherosclerosis. However, there was a significant inverse association in those with atherosclerosis. The potential confounding factor adjusted odd ratios and 95% confidence intervals (95% CIs) were 1.49 (95% CI 1.17–1.90) for participants without atherosclerosis and 0.49 (95% CI 0.24–0.98) for those with atherosclerosis. The present study demonstrates that thyroid cysts have clinical implications because thyroid cysts support thyroid hormone activity. Our findings provide sufficient evidence to develop a risk assessment for hypertension for the general population, even though further research is required.

Excess winter mortality and stalling international improvements in life expectancy and mortality rates

In the UK, government austerity has been suggested as a major reason for the stalling of life expectancy improvements and age-standardised mortality rates. However, these trends have also been observed in many other countries. Influenza has been suggested as a potential confounding factor, as this condition contributes significantly to excess winter mortality (EWM) rates each year. This study uses calculated EWM rates in 64 countries with more than 12 000 deaths per annum to show that the decade before the financial crash was characterised by lower than average rates of EWM. The observed international stalling in life expectancy may therefore have been happening as early as the year 2000 but may have been partly masked by a decade of lower than usual winter deaths. From a health service perspective, EWM is also a source of winter bed pressures because of the associated medical admissions. The coincidental decade of low EWM rates may have also created a false picture of low winter demand, to which managers will have responded by trimming resources. This will, in part, have contributed to current winter pressures as EWM rates have returned to more ‘normal’ levels.