Noradrenergic Blood Pressure Dysregulation and Cytosolic Calcium in Primary Hyperparathyroidism

Schiffl, Helmut; Sitter, Thomas; Lang, Susanne M.

doi:10.1159/000174161

Cited by 14 publications

(10 citation statements)

References 9 publications

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“…According to some authors, this prevalence may vary from 20 to 80%. [2][3][4][5] The results of our study confirm and extend these data reported in the 30,31 (c) renal function injury; 7,8 (d) activation of the renin-angiotension-aldosterone system; [32][33][34] (e) activation of the sympathetic nervous system; 26,29 (f) activation of the endothelin 35 and adrenomedullin 36 systems.…”

Section: Discussionsupporting

confidence: 83%

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

et al. 2005

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The purpose of our study was to evaluate the behaviour of blood pressure (BP) by ambulatory monitoring of blood pressure (AMBP) in 53 patients with primary hyperparathyroidism (PHPT) compared to 100 essential hypertensive (EH) and 31 healthy subjects (HS). The correlations between calcium-phosphorus metabolism and haemodynamic parameters in all groups are included in the study. AMBP was performed using the oscillometric technique (Space-Labs, 90207, Redmond, WA, USA) and the following AMBP parameters were evaluated: average day time systolic (S) and diastolic (D) blood pressure (BP) and heart rate (HR) (when awake), average night time SBP, DBP and HR (when asleep) and average 24-h-SBP, DBP and HR. The definition of 'dipper' or 'non-dipper' subjects was established if night time SBP and DBP fall was 410% and o10%, respectively. In total, 25 PHPT patients (47.2%) were hypertensive (HT-PHPT) and 28 PHPT (52.8%) were normotensive (NT-PHPT). Mean 24-h-SBP and DBP obtained by AMBP was higher in HT-PHPT (Po0.05) and EH (Po0.05) than in NT-PHPT and HS. The multiple linear regression has shown that in PHPT-HT patients ionized calcium is an independent factor for the rise of 24-h-DBP values (r: 0.497; Po0.05) and daytime DBP values (r: 0.497; Po0.05). In 56% of HT-PHPT patients there is an absence of physiological BP nocturnal fall ('non-dipper'), which is statistically significant (Po0.05) compared with 'nondipper' EH patients (30%). In conclusion, in our study the prevalence of hypertension in PHPT was 47%. AMBP revealed that the 'non-dipping 'pattern was much higher in HT-PHPT patients in respect to EH patients.

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Section: Discussionsupporting

confidence: 83%

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

et al. 2005

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“…The close correlation between PTH and intracellular calcium suggests that PTH may act as an ionophore for calcium entry into cells and perhaps reflect a pre-hypertensive condition in normotensive patients with pHPT. Increased cytosolic free calcium in platelets has been shown to be elevated also in untreated hypertensive patients with pHPT (Schiffl et al 1997). Moreover, parathyroidectomy of these patients resulted in the reduction of cytosolic free calcium and led to normotension.…”

Section: Effect Of Primary Hyperparathyroidism On Blood Pressurementioning

confidence: 99%

Parathyroid adenomas and cardiovascular risk.

Torre¹,

Wass²,

Turner³

2003

Endocrine-Related Cancer

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In recent decades, primary hyperparathyroidism (pHPT) has changed its clinical presentation from a disease with bone and renal involvement to a frequently asymptomatic disorder detected on routine biochemistry. Nevertheless, it remains unclear whether patients with untreated mild asymptomatic hyperparathyroidism are at risk for other complications such as increased morbidity and mortality from cardiovascular diseases. There are limited data on the incidence of cardiovascular abnormalities in mild pHPT. However, pHPT has been associated with increased risk of death from cardiovascular disease, hypertension, left ventricular hypertrophy (LVH), valvular and myocardial calcifications, impaired vascular reactivity, alterations in cardiac conduction, impaired glucose metabolism, dyslipidaemia, and alterations in body composition. The nature of some of these associations is in question, because cure of pHPT does not lead to improvement of the cardiovascular disorder e.g. hypertension. In contrast, currently available data suggest that LVH, impaired glucose metabolism and dyslipidaemia may improve after surgery and that successful parathyroidectomy could decrease the excess mortality in patients with pHPT due to cardiovascular disease.

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“…In some studies, it has been observed that PTH decreases intracellular calcium [28, 39, 40, 41, 42], and it was even observed that this hormone acts in the vascular smooth muscle by blocking the entrance of this ion through voltage-dependent L-type calcium channels [39, 40, 41, 42]. There are also studies in which PTH did not alter intracellular calcium [43]. PTH may also display calciotropic properties in cardiac cells [44], osteoblast-like cells [45], renal proximal tubular cells [46], and hepatic cells [47]and could even cause a transient increase in intracellular calcium in cultured vascular smooth muscle cells opening calcium channels [48].…”

Section: Introductionmentioning

confidence: 99%

Parathyroid Hormone and Calcitriol in Hypertension Caused by Dietary Calcium Deficiency in Rats

López‐Miranda

Civantos²,

Blasco³

et al. 1998

J Vasc Res

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Hypertension caused by calcium deficiency in the diet has been linked with an increase in parathyroid hormone (PTH) and calcitriol levels. We evaluated arterial blood pressure (ABP), PTH, and calcitriol in normotensive Sprague-Dawley rats (SDR) and in spontaneously hypertensive rats (SHR) fed from weaning on a control diet with a normal calcium content (1%) or a low-calcium diet (0.1%). The calcemia was also measured in the rats by colorimetric methods. The low-calcium diet decreased the calcemia in both strains and brought about an increase in the ABP which was significant in adult SDR and particularly noticeable during the early hypertensive phase in SHR. The rats fed on this diet had higher hormonal plasma levels when compared with the corresponding values in rats fed on the control diet. In particular, the SDR fed on the low-calcium diet showed much higher PTH (122.6 ± 31.0 pg/ml, p ≤ 0.05) and calcitriol (458.0 ± 13.1 pg/ml, p ≤ 0.01) values than the SDR fed on the control diet (PTH 31.7 ± 2.80 pg/ml; calcitriol 292.1 ± 17.5 pg/ml). These endocrine alterations could justify the increase in ABP caused by dietary calcium deficiency in normotensive rats. Nevertheless, the results of this study indicate that the modifications of the ABP caused by the low-calcium diet in SHR could not be correlated with significant increases in these hormones.

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Noradrenergic Blood Pressure Dysregulation and Cytosolic Calcium in Primary Hyperparathyroidism

Cited by 14 publications

References 9 publications

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

Parathyroid adenomas and cardiovascular risk.

Parathyroid Hormone and Calcitriol in Hypertension Caused by Dietary Calcium Deficiency in Rats

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