Title:Cardiovascular Risk in Patients with Primary Hyperparathyroidism
Volume: 26
Issue: 43
Author(s): Symeon Tournis*, Konstantinos Makris, Etienne Cavalier and George Trovas
Affiliation:
- Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, KAT Hospital, Athens,Greece
Keywords:
Primary hyperparathyroidism, cardiovascular disease, calcium, parathyroid hormone, hypertension, parathyroidectomy.
Abstract: Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders characterized
by parathyroid hormone (PTH)-dependent hypercalcemia. Cardinal features include low trauma fractures,
nephrolithiasis, and chronic kidney disease. Several experimental studies established that parathyroid hormone
exerts actions on the cardiovascular (CV) system, including vasodilatation and positive inotropic and
chronotropic effects. Observational studies, especially in severe cases, report a higher prevalence of hypertension,
diabetes mellitus, lipid abnormalities, endothelial dysfunction, arrhythmias, and left ventricular hypertrophy
in patients with PHPT, while the risk of CV events seems to be increased in severe cases. However, the effect
of surgery is inconsistent on CV abnormalities and, more importantly, on CV disease (CVD) events, especially
in mild cases. In the current review, we describe the available evidence linking PHPT and CVD, as well
as the effect of surgical management and pharmacological treatment on CVD manifestations in patients with
PHPT. Based on the current evidence, CVD is not considered an indication for surgery.
