Volume 29, Issue 163, September 2025

Successful antihypertensive therapy with metoprolol in a patient with Graves’ disease following Hashimoto’s thyroiditis: A Case Report

Klaudia Miklusiak^1♦, Karol Miklusiak²

¹Independent Medical Practitioner - Daleszyce, Poland
²Independent Medical Practitioner - Kielce, Poland

^♦Corresponding author
Klaudia Miklusiak, Independent Medical Practitioner - Daleszyce, Poland

ABSTRACT

Introduction: Graves' disease (GD) and Hashimoto's disease (HT) are autoimmune diseases of the thyroid gland, with different pathophysiological mechanisms. In GD, antibodies against the TSH receptor cause hyperthyroidism, while in HT, there are anti-TPO and anti-TG antibodies, which cause hypothyroidism. The case illustrates the diagnostic difficulties in the transition from HT to GD, which can be masked by general symptoms and lead to delays in diagnosis. In hyperthyroidism, arterial hypertension often results from the predominance of the sympathetic nervous system; therefore, treatment with beta-blockers is justified. Treatment of hypertension in the course of GD differs from that of primary arterial hypertension. Case report: The case describes a 37-year-old patient with a history of HT who converted to GD. With disease progression, an increase in blood pressure (HBPM) was observed, despite normal thyroid hormone levels after introduction of thiamazole at 10 mg twice daily. The implementation of metoprolol effectively lowered the blood pressure. Conclusion: Any patient diagnosed with HT should be monitored for the development of symptoms of hyperthyroidism. Cardioselective beta-blockers, such as metoprolol, are effective in treating hypertension secondary to GD and should be considered in any patient with contraindications to propranolol.

Keywords: hypertension; metoprolol; Graves’ disease; Hashimoto’s disease

Medical Science, 2025, 29, e153ms3668

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DOI: https://doi.org/10.54905/disssi.v29i163.e153ms3668

Published: 05 September 2025