INS and hyperthyroidism: Subtle changes in thyroid hormone concentrations, like subclinical hypothyroidism or hyperthyroidism, could lead to a significant increase in vascular morbidity and mortality [29, 30], while lower normal thyroid function, especially lower FT4 levels may increase systemic vascular resistance, decrease arterial compliance and affect BP; Finally, lower normal thyroid function is reported to be a risk factor for diabetes, especially in individuals with prediabetes [31], the mechanism of which could be attributed to a decreased insulin sensitivity and glucose tolerance.