Is Normocalcemic Primary Hyperparathyroidism Harmful or Harmless?
Open Access
- 1 June 2015
- journal article
- other
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 100 (6), 2420-2424
- https://doi.org/10.1210/jc.2014-4432
Abstract
Context: Primary hyperparathyroidism (PHPT) is reported to be associated with an increased frequency of hypertension, however, information in this regard is sparse in relation to normocalcemic primary hyperparathyroidism (NPHPT). Objective: The aim of this study was to determine the association between NPHPT and blood pressure. Design, Setting, and Patients: We retrospectively enrolled 940 patients who visited the Fujian Provincial Hospital between September 2010 and December 2013 with a measured serum parathyroid hormone (PTH) and calcium level. Among them, 11 patients were diagnosed with NPHPT, while 296 cases with normal PTH and albumin-adjusted serum calcium. Main Outcomes Measures: Systolic blood pressure (SBP), diastolic blood pressure (DBP), intact serum PTH, and serum calcium were recorded. Results: There were no significant differences between subjects identified with NPHPT and those with normal PTH in terms of age, sex, body mass index, serum calcium, 25-Hydroxyvitamin D, serum creatinine, fasting plasma glucose, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein. The subjects with a diagnosis of NPHPT had higher levels of SBP (141.9 ± 20.2 vs 131.2 ± 16.5, P = .041) and DBP (85.2 ± 12.4 vs 76.8 ± 10.3, P = .026) than the subjects in the cohort with normal PTH. After adjustment for all potential confounders, risks (odds ratios and 95% confidence interval) of SBP and DBP in NPHPT patients were 1.035 (1.000, 1.071) and 1.063 (1.004, 1.125), respectively (P < .05). Conclusions: The NPHPT had higher risk of high blood pressure than subjects with normal PTH. It is worth considering the necessity of more aggressive therapeutic intervention aimed to normalize PTH even if patients with NPHPT continue to be normocalcemic.Keywords
This publication has 24 references indexed in Scilit:
- High serum parathyroid hormone and calcium are risk factors for hypertension in Japanese patientsEndocrine Journal, 2014
- Diagnosis and management of primary hyperparathyroidism: a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and MetabolismArchives of Endocrinology and Metabolism, 2013
- Normocalcemic primary hyperparathyroidism: A newly emerging disease needing therapeutic interventionHormones, 2012
- Cardiovascular risk factors and arterial rigidity are similar in asymptomatic normocalcemic and hypercalcemic primary hyperparathyroidismActa Endocrinologica, 2010
- Normocalcemic Primary Hyperparathyroidism: Further Characterization of a New Clinical PhenotypeJournal of Clinical Endocrinology & Metabolism, 2007
- Population based study on serum ionised calcium, serum parathyroid hormone, and blood pressure. The Tromso studyActa Endocrinologica, 1999
- Serum Calcium and Cardiovascular Risk Factors and DiseasesHypertension, 1999
- Death risk factor analysis in primary hyperparathyroidismEuropean Journal of Clinical Investigation, 1998
- Increased risk of death from primary hyperparathyroidism — an updateEuropean Journal of Clinical Investigation, 1998
- Normocalcemic primary hyperparathyroidismThe American Journal of Medicine, 1969