Primary hyperparathyroidism and cardiovascular risk. Is there a connection?

Abstract

In primary hyperparathyroidism parathormone (ΡΤΗ) is secreted autonomously and produce increase of calcium and decrease of phosphorus in the serum of the affected patients.In this study the newer facts in the medical literature about the influence of primary hyperparathyroidism in cardiovascular system are presented. Big studies have investigated the role of several factors affected in primary hyperparathyroidism. It seems that the increase of PTH affects the cardiovascular system in various ways. But there is a debate about the mild cases of hyperparathyroidism and short-standing disease. Key words: parathyroid glands; hyperparathyroidism; adenoma; cardiovascular IntroductionThe parathyroid glands are 4 in 80-87% of cases in humans, but in the rest of cases the number of parathyroid glands vary from 2 to 8. The main role of these glands is the produce of parathormone (PTH). This hormone with vitamin D and calcitonin are the main coordinators of the metabolism of calcium in human body. The diseases of the parathyroid glands can be divided based on the amount of PTH secretion and their function. Only one gland or all of these glands may overfunction or hypofunction. In the latter case we have to do with hypoparathyroidism and in the first case with hyperparathyroidism [1,2]. Primary hyperparathyroidism is a common disease as it is the third endocrine disease in frequency, after diabetes mellitus and hyperthyroidism. It is estimated to occur in 0.1-0.3% of the general population. It is thought to occur more commonly in elderly, in females and after the irradiation of the head and neck area [3,4]. A single adenoma is the main reason of primary hyperparathyroidism in 80-85% of cases. Clinical manifestations of this endocrine disease seem to be affected from the weight of the adenoma of the parathyroid gland and the longstanding disease [1,2,5]. In this study we are going to resume the current opinions in medical literature for the role of the hypersecretion of PTH in primary hyperparathyroidism in cardiovascular system. Primary hyperparathyroidism as a hyperfunction state of parathyroid glands leads to increased calcium and decreased phosphorus in the serum of the patients. The PTH is usually increased and vitamin D is usually lower than normal or normal. Clinical manifestations and symptoms of primary hyperparathyroidism may be mild or severe, profound or asymptomatic. The main characteristic of this disease is that there may be exacerbation and recession and there are no characteristic symptoms attributed to it. This phenomenon results to the fact that these patients remain underdiagnosed for many years, especially in the past. General symptoms of primary hyperparathyroidism are lose of body weight, fatigue, anorexia, musculoskeletal, osteoporosis, urinary stones, psychiatric symptoms and many other [1,2,6,7]. In cardiovascular system, symptoms and manifestations attributed to primary hyperparathyroidism are myocardial infarction, angina, arrhythmias, hypertension, heart failure, calcifications of cardiac ...