With the improvement of the economic standard of living and the increase of adverse lifestyle factors, the prevalence of primary hypertension in China has increased rapidly in recent years, becoming one of the most common chronic diseases. It is well known that many diseases can lead to elevated blood pressure, can hyperthyroidism lead to elevated blood pressure? Hyperthyroidism is an endocrine disorder caused by excessive secretion of thyroid hormones, and the cardiovascular system is the main target organ for the action of thyroid hormones, so cardiovascular abnormalities are one of the common symptoms of hyperthyroidism. The increased thyroid hormones in the body of hyperthyroidism patients stimulate the cardiovascular system to manifest a series of cardiovascular symptoms, among which hypertension is a common symptom, that is, hyperthyroid hypertension. 1. Who is prone to hyperthyroidism? As with many diseases, the cause of hyperthyroidism is not fully understood. Statistics show that young people, especially young women, are prone to hyperthyroidism. People with hyperthyroidism in their families are at higher risk of developing the disease than normal people. 2. Clinical manifestations of hyperthyroidism Clinical symptoms of hyperthyroidism include tachycardia, hyperphagia, weight loss, agitation, and goiter. Patients with hyperthyroidism often have abnormal blood pressure, manifested as increased systolic blood pressure (commonly known as high pressure), decreased diastolic blood pressure (commonly known as low pressure), and increased pulse pressure difference (systolic – diastolic). As systolic blood pressure increases and diastolic blood pressure decreases, the pulse pressure difference increases. Therefore, increased pulse pressure difference is a characteristic of hyperthyroidism hypertension, while the blood pressure of hypertension generally does not have increased pulse pressure difference. 3. The mechanism of hyperthyroidism hypertension is due to an increase in systolic blood pressure, which is caused by an increase in the amount of blood discharged from the heart. Increased thyroid hormone can enhance the contractility of the heart muscle directly, or indirectly by increasing the sensitivity of the heart muscle to catecholamines. Increased myocardial contractility increases cardiac blood output, resulting in increased pressure in the large arteries of the heart during systole, i.e., systolic blood pressure. Due to increased heat production, peripheral vasodilation and increased arteriovenous anastomotic branches, resulting in normal or slightly reduced diastolic blood pressure. 4.Diagnosis and differential diagnosis of hyperthyroidism hypertension (1) First of all, confirm whether there is hyperthyroidism or not: patients with hyperthyroidism often have problems such as easy hunger, hyperphagia, palpitations, insomnia and agitation. If you have the above symptoms, you need to have a thyroid function test. FT3, free triiodothyronine, is the active form of free thyroid hormone in the blood; FT4, free tetraiodothyronine, is the free thyroid hormone in the blood; TSH, serum thyrotropin, is a hormone released by the pituitary gland to stimulate the thyroid gland to secrete thyroid hormone; the most typical feature of hyperthyroidism is that FT3 and FT4 are elevated and TSH is decreased. To determine the cause of hyperthyroidism, these two indicators are usually referred to: TPOAb, thyroid peroxidase antibody, a type of thyroid autoimmune antibody; TGAb, thyroglobulin antibody, a type of thyroid autoimmune antibody. Hypertension caused by hyperthyroidism mainly manifests as elevated systolic blood pressure, decreased diastolic blood pressure, and increased pulse pressure. Hypertension in hyperthyroidism rarely manifests as elevated diastolic blood pressure. If a patient diagnosed with hyperthyroidism develops a significant increase in diastolic blood pressure, it suggests a combination of primary hypertension or the presence of other secondary hypertension. Therefore, we need to be careful when diagnosing hyperthyroidism hypertension. 5, hyperthyroidism hypertension treatment and precautions (1) If the diagnosis is hyperthyroidism caused by hypertension, then the root cause of hyperthyroidism needs to be addressed first. Treatment of hyperthyroidism includes anti-hyperthyroidism treatment and symptomatic treatment. Anti-hyperthyroidism treatment includes medication, radioactive iodine treatment, and surgery. Among them, there are two commonly used drugs: methimazole and propylthiouracil. They are selected according to the following rules: the general population is given priority to methimazole, which requires only 1 dose per day and has a slightly stronger antimitotic effect than propylthioxypyrimethamine. Propylthiouracil, on the other hand, requires 2-3 doses per day. Due to the significant fetal malformation effect of methimazole, pregnant women should only take propylthiouracil during the first trimester of pregnancy; liver damage is more common with propylthiouracil than with methimazole, so pregnant women may consider switching back to methimazole in the middle to late stages of pregnancy. If the medication is not effective, a specialist should be consulted for radioactive iodine 131 or surgical removal of part of the thyroid gland. Patients with elevated blood pressure should rest as much as possible and avoid being too irritable and agitated. With the control of hyperthyroidism, most patients’ systolic and diastolic blood pressure and blood pressure fluctuation pattern can be normalized, so it is not necessary to use antihypertensive drugs. Only when the systolic blood pressure is extremely high, antihypertensive drugs should be used under the guidance of a doctor. If systolic blood pressure is still ≥ 140 mmHg, and/or diastolic blood pressure ≥ 90 mmHg after normal thyroid function, seek medical attention as soon as possible to find other causes of elevated blood pressure. (2) The diet of patients with hyperactive hypertension also requires avoiding foods with high cholesterol, avoiding animal oil, it is better to choose vegetable oil cooking is better, patients avoid smoking and drinking, to eat more vegetables and fruits. Avoid eating hot foods such as ginger, coffee, cocoa, etc., as well as avoid eating foods with high iodine content. Usually eat more nutritious light food, such as: rice porridge, eggs, lean meat, etc., will help the recovery of the patient’s body.