SERPINE1 and endothelial dysfunction: Hypothyroidism is linked to atherosclerosis due to dyslipidemia (elevated LDL cholesterol, decreased HDL cholesterol, and increased lipoprotein-a (Staels et al., 1990; Kung et al., 1995)), diastolic hypertension (increased arterial stiffness (Obuobie et al., 2002)), endothelial dysfunction, as well as elevated homocysteine levels (Guthikonda and Haynes, 2006), high C-reactive protein levels, and elevated plasminogen activator inhibitor-1 levels, exacerbating or leading to atherosclerosis and ischemic heart disease (Ichiki, 2010).