Primary hyperparathyroidism predicts hypertension: Results from the National Inpatient Sample

Kalla, Aditi; Krishnamoorthy, Parasuram; Gopalakrishnan, Akshaya; Garg, Jalaj; Patel, Neinesh C; Figueredo, Vincent M.

doi:10.1016/j.ijcard.2016.11.080

Cited by 37 publications

(23 citation statements)

References 23 publications

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“…We have demonstrated that patients with PHPT have better blood pressure control 3.3 years after surgery compared to before surgery, with no significant changes in their blood pressure medication. In line with this, a recent study reported that PHPT is an independent risk factor for hypertension [25]. The present study also sheds some ▶table 2 New diagnoses acquired during 3.3 years follow-up after surgery for primary PHPT.…”

Section: Discussionsupporting

confidence: 90%

Surgery Significantly Improves Neurocognition, Sleep, and Blood Pressure in Primary Hyperparathyroidism: A 3-Year Prospective Follow-Up Study

et al. 2017

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Surgery for primary hyperparathyroidism (PHPT) improves health-related quality of life (HRQoL), but it is unclear whether the effects are sustained after medium-term (>2 years) follow-up, and whether the results on some or all dimensions of HRQoL will reach that of the general population. We performed a follow-up of HRQoL on average 3.3 years after surgery for PHPT using the 15D in our patient cohort (n=124) and compared the results to those of an age- and gender-standardized general population (n=1099). We studied self-reported blood pressure and current medications; new comorbidities were retrieved from electronic patient records. A total of 104 (83%) patients [eight with serum calcium (1.34-1.46 mmol/l)] returned the questionnaires. After a follow-up of 3.3 years (range 23 to 55 months), systolic and diastolic blood pressure had decreased significantly compared to baseline (the situation before surgery, p<0.001). Thirty-four (33%) had acquired a new diagnosis (range 1-7), the most common being cardiovascular disease and cancer. Mean 15D score was significantly better compared to baseline (p<0.001), the dimensions of sleeping, mental function, discomfort and symptoms, and depression had further improved (p<0.01), and no longer differed from that of the general population. In PHPT, after >2 years follow-up, surgery improves blood pressure and restores neurocognitive function and sleep to the level of the general population. The improvements observed in overall HRQoL at one year after surgery are sustained, but overall HRQoL does not reach that of the general population.

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Section: Discussionsupporting

confidence: 90%

Surgery Significantly Improves Neurocognition, Sleep, and Blood Pressure in Primary Hyperparathyroidism: A 3-Year Prospective Follow-Up Study

et al. 2017

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“…In spite of the reported bidirectional relationship between PTH and the RAAS [38,39], we did not observe differences in plasma renin and aldosterone concentrations, or in volume homeostasis (ECW and ECW balance), between the PTH tertiles. These findings correspond to the matching 1,25(OH) PTH has been directly associated with the level of peripheral BP [2,3], and the risk of hypertension in patients with primary hyperparathyroidism [4,40] and in the general population [5,40]. In 3620…”

Section: Discussionsupporting

confidence: 70%

Parathyroid hormone may play a role in the pathophysiology of primary hypertension

Oinonen

Tikkakoski

Koskela

et al. 2021

Endocrine Connections

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Parathyroid hormone has been related with the risk of hypertension, but the matter remains controversial. We examined the association of parathyroid hormone with central blood pressure and its determinants in 622 normotensive or never-treated hypertensive subjects aged 19-72 years without diabetes, cardiovascular or renal disease, or cardiovascular medications. The methods were whole-body impedance cardiography and analyses of pulse wave and heart rate variability. Cardiovascular function was examined in sex-specific tertiles of plasma parathyroid hormone (mean concentrations 3.0, 4.3 and 6.5 pmol/l, respectively) during head-up tilt. Explanatory factors for haemodynamics were further investigated using linear regression analyses. Mean age was 45.0 (SD 11.7) years, body mass index 26.8 (4.4) kg/m2, seated office blood pressure 141/90 (21/12) mmHg, and 309 subjects (49.7%) were male. Only five participants had elevated plasma parathyroid hormone and calcium concentrations. Highest tertile of parathyroid hormone presented with higher supine and upright aortic diastolic blood pressure (p<0.01) and augmentation index (p<0.01), and higher upright systemic vascular resistance (p<0.05) than the lowest tertile. The tertiles did not present with differences in pulse wave velocity, cardiac output, or measures of heart rate variability. In linear regression analyses, parathyroid hormone was an independent explanatory factor for aortic systolic (p=0.005) and diastolic (p=0.002) blood pressure, augmentation index (p=0.002), and systemic vascular resistance (p=0.031). To conclude, parathyroid hormone was directly related to central blood pressure, wave reflection, and systemic vascular resistance in subjects without cardiovascular comorbidities and medications. Thus, parathyroid hormone may play a role in the pathophysiology of primary hypertension.

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“…Среди всех случаев заболевания артериальной гипертензией (АГ) до 5-15% развивается вследствие вторичного повышения артериального давления (АД), чаще на фоне эндокринной патологии. Самой распространенной эндокринопатией, ассоциированной с АГ, является первичный гиперальдостеронизм, однако роль других заболеваний, таких как первичный гиперпаратиреоз (ПГПТ), требует изучения [1,2].…”

Section: ââåäåíèåunclassified

“…В когорте пациентов с ПГПТ получены противоречивые результаты в отношении изменения концентрации параметров РААС, а также уровня ПТГ при приеме препаратов, влияющих на активность данной системы регуляции АД [22,23]. Тем не менее представлены клинические случаи сочетанного развития ПГПТ и альдостеронпродуцирующей опухоли надпочечника [24][25][26], при этом предполагается, что гиперпаратиреоз и гиперальдостеронизм потенцируют патологические эффекты друг друга на сердечно-сосудистую систему [2,27].…”

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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Primary hyperparathyroidism predicts hypertension: Results from the National Inpatient Sample

Cited by 37 publications

References 23 publications

Surgery Significantly Improves Neurocognition, Sleep, and Blood Pressure in Primary Hyperparathyroidism: A 3-Year Prospective Follow-Up Study

Surgery Significantly Improves Neurocognition, Sleep, and Blood Pressure in Primary Hyperparathyroidism: A 3-Year Prospective Follow-Up Study

Parathyroid hormone may play a role in the pathophysiology of primary hypertension

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

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