Plasma parathyroid hormone and cardiovascular disease in treatment‐naive patients with primary hyperparathyroidism: The <scp>EPATH</scp> trial

Wetzel, Julia; Pilz, Stefan; Grübler, Martin; Fahrleitner‐Pammer, Astrid; Dimai, Hans Peter; Lewinski, Dirk von; Kolesnik, Ewald; Perl, Sabine; Trummer, Christian; Schwetz, Verena; Meinitzer, Andreas; Belyavskiy, Evgeny; Völkl, Jakob; Catena, Cristiana; Brandenburg, Vincent; März, Winfried; Pieske, Burkert; Brussee, Helmut; Tomaschitz, Andreas; Verheyen, Nicolas

doi:10.1111/jch.13064

Cited by 14 publications

(11 citation statements)

References 41 publications

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“…A similar close relationship between PWV and LVMI has also been shown in hemodialysis patients [20]. Also a very close relationship between PWV and LVMI has been shown in patients with PHP [21,22]. In our study, we found a very close relationship between LVMI and CF-PWV in patients with PHP.…”

Section: Discussionsupporting

confidence: 89%

Carotid–femoral pulse wave velocity is significantly increased in newly diagnosed hypertensive patients with primary hyperparathyroidism and significantly related with serum calcium level

et al. 2020

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Background Primary hyperparathyroidism (PHP) is a rare cause of secondary hypertension (HT), but in patients with PHP, HT is very common and 20-80% of patients have HT. The aim of this study was to evaluate the change in carotid-femoral pulse wave velocity (CF-PWV) in hypertensive patients with PHP, and was to determine the clinical, laboratory, and echocardiographic parameters associated with CF-PWV. Methods The study included 83 newly diagnosed hypertensive patients with PHP and 83 patients with newly diagnosed essential HT without PHP. All patients underwent echocardiography and CF-PWV measurements. Results In patients with PHP, blood urea nitrogen, hs-CRP, uric acid, serum and urine calcium, parathyroid hormone level, CF-PWV value, LV wall thickness, LVMI, aortic and left atrium (LA) diameter, and presence of LVH and CF-PWV > 10 m/s were higher, and serum phosphorus levels were lower. Serum calcium, LA diameter, and LVMI values were closely correlated with CF-PWV. In the ROC analysis, the AUROC was calculated as 0.825 for calcium level to determine the patients with increased CF-PWV. When the serum calcium value was taken as 10 mg/dL, it was determined with CF-PWV > 10 m/s were 79.5% sensitivity and 78.2% specificity. Conclusion CF-PWV significantly increases in newly diagnosed hypertensive patients with PHP and significantly related to serum calcium level. To protect against target organ damage, high serum calcium levels should be monitored as well as blood pressure in hypertensive patients with PHP.

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Section: Discussionsupporting

confidence: 89%

Carotid–femoral pulse wave velocity is significantly increased in newly diagnosed hypertensive patients with primary hyperparathyroidism and significantly related with serum calcium level

et al. 2020

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“…A recent study demonstrated an independent association between PTH and nocturnal systolic blood pressure, mean 24-hour pulse wave velocity, and left ventricular mass index. PTH may induce vascular and cardiac remodeling in primary hyperparathyroidism [28]. However, some studies did not support this hypothesis [9,10].…”

Section: Discussionmentioning

confidence: 99%

The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism

et al. 2018

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Aim: The studies conducted to investigate the association between biochemical manifestations of hyperparathyroidism such as serum parathyroid hormone, serum calcium, and serum phosphate levels, and parathyroid adenoma weight and volume have conflicting results. We aimed to investigate whether there is an association of preoperative size of adenoma with laboratory parameters and cardio-metabolic risk factors in patients with primary hyperparathyroidism. Material and Method: Seventy-five patients with PHPT and 96 control subjects were enrolled in the study. Demographic, anthropometric and biochemistry data were recorded. Correlation analysis was used for determining the relation between adenoma volume and cardio-metabolic parameters. Preoperative adenoma volume was calculated by the ellipsoid model formula. Results: Mean age was similar between groups (52.69 ± 10.91 to 53.33 ± 7.70, p:0.667). Mean size of adenoma was 1.42 ± 2.62 cm3. Size of adenoma was positively correlated with calcium and parathormone levels and negatively correlated with vitamin D level (p<0.05). Size of adenoma was not correlated with cardio-metabolic risk factors including systolic blood pressure, diastolic blood pressure, age, fasting plasma glucose, lipid profile, body mass index, carotis intima media thickness, CRP and HOMA-IR (p>0.05). PTH, calcium, phosphorus or vitamin D levels were also not correlated cardio-metabolic risk factors. Conclusions: Adenoma volume has a correlation with parathormone, calcium, phosphorus and vitamin D levels, however, it is not associated with cardio-metabolic risk factors.

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“…От 40 до 65% пациентов с ПГПТ имеют сопутствующую АГ, что наряду с другими морфофункциональными изменениями обусловливает повышенную сердечно-сосудистую заболеваемость и смертность [3]. При этом отличительной особенностью является нарушение суточного ритма АД, а именно отсутствие ночного снижения («non-dipping») [4,5]. Конкретные патогенетические механизмы повышения АД при ПГПТ до сих пор остаются неизученными, ключевую роль может играть как гиперкальциемия, так и повышение концентрации паратгормона (ПТГ).…”

Section: ââåäåíèåunclassified

“…Несмотря на высокую распространенность, в настоящее время сопутствующая кардиоваскулярная патология, включая АГ, не входит в перечень показаний к хирургическому лечению ПГПТ, поскольку положительное влияние паратиреоидэктомии (ПТЭ) на состояние сердечно-сосудистой системы остается спорным [4,6,9,28]. В том числе неоднозначны результаты исследований динамики показателей РААС после радикального удаления опухолей ОЩЖ [29][30][31][32].…”

Section: ââåäåíèåunclassified

Dynamic changes of renin-angiotensin-aldosterone system parameters after surgery of primary hyperparathyroidism

Dobreva

Bibik

Eremkina

et al. 2020

Terapevticheskii arkhiv

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Aim.To study an activity of the Renin-Angiotensin-Aldosterone System (RAAS) components in patients with primary hyperparathyroidism (PHPT) before and after parathyroidectomy (PTE). Materials and methods.A comparative study of patients with PHPT and control group. The first stage of the study included 56 patients with PHPT (group 1) before and on the third day after PTE. The second stage was carried out in 27 patients with remission of PHPT (group 2). All patients and healthy volunteers were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin activity PRA, serum aldosterone, angiotensin II AT II). Results.Patients with active PHPT demonstrated changes in RAAS activity (lower PRA, higher AT II level) comparing to control group, that have statistical significance in group 1 (p0.001 for both parameters). There were no significant differences in aldosterone levels (p1=0.090;p2=0.140). On the third day after PTE (group 1), a decrease in aldosterone level (p=0.009) and a tendency to decrease in PRA (p=0.030) were detected. However, an increase in PRA (p=0.018), a decrease in AT II concentration (p=0.032) comparing to the initial values and their normalization were observed 12 months after surgery when permanent normal serum calcium and PTH levels had been achieved. There were controversial correlations between the parameters of phosphorus-calcium metabolism and RAAS. The influence of angiotensin-converting-enzyme inhibitors and AT II receptor blockers on phosphorus-calcium metabolism in patients with PHPT was not observed. Conclusion.In patients with PHPT, there were no сlear correlations of phosphorus-calcium metabolism parameters with RAAS, however an increase of AT II concentration was noted, that can take part in a development of hypertension for this endocrinopathy. PTE can have a positive effect on AT II level.

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Plasma parathyroid hormone and cardiovascular disease in treatment‐naive patients with primary hyperparathyroidism: The EPATH trial

Cited by 14 publications

References 41 publications

Carotid–femoral pulse wave velocity is significantly increased in newly diagnosed hypertensive patients with primary hyperparathyroidism and significantly related with serum calcium level

Carotid–femoral pulse wave velocity is significantly increased in newly diagnosed hypertensive patients with primary hyperparathyroidism and significantly related with serum calcium level

The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism

Dynamic changes of renin-angiotensin-aldosterone system parameters after surgery of primary hyperparathyroidism

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