Surgery
Volume 146, Issue 6 , Pages 1042-1047 , December 2009

Parathyroidectomy decreases systolic and diastolic blood pressure in hypertensive patients with primary hyperparathyroidism

  • Aliya Heyliger, MD

      Affiliations

    • Division of General Internal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
    • ,
  • Vin Tangpricha, MD, PhD

      Affiliations

    • Division of Endocrinology, Diabetes and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA
    • ,
  • Collin Weber, MD

      Affiliations

    • Department of Surgery, Emory University School of Medicine, Atlanta, GA
    • ,
  • Jyotirmay Sharma, MD

      Affiliations

    • Department of Surgery, Emory University School of Medicine, Atlanta, GA
    • Corresponding Author InformationReprint requests: Jyotirmay Sharma, MD, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road NE, Atlanta, GA 30322.

,Accepted 24 September 2009.

References 

  1. NIH conference. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement. Ann Intern Med. 1991;114:593–597
  2. Scholz DA, Purnell DC. Asymptomatic primary hyperparathyroidism. 10-year prospective study. Mayo Clin Proc. 1981;56:473–478
  3. Nainby-Luxmoore JC, Langford HG, Nelson NC, Watson RL, Barnes TY. A case-comparison study of hypertension and hyperparathyroidism. J Clin Endocrinol Metab. 1982;55:303–306
  4. McCarron DA, Pingree PA, Rubin RJ, Gaucher SM, Molitch M, Krutzik S. Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak. Hypertension. 1980;2:162–168
  5. Broulik PD, Horký K, Pacovský V. Blood pressure in patients with primary hyperparathyroidism before and after parathyroidectomy. Exp Clin Endocrinol. 1985;86:346–352
  6. Kovács L, Góth MI, Szabolcs I, Dohán O, Ferencz A, Szilágyi G. The effect of surgical treatment on secondary hyperaldosteronism and relative hyperinsulinemia in primary hyperparathyroidism. Eur J Endocrinol. 1998;138:543–547
  7. Nilsson IL, Aberg J, Rastad J, Lind L. Maintained normalization of cardiovascular dysfunction 5 years after parathyroidectomy in primary hyperparathyroidism. Surgery. 2005;137:632–638
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  9. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–1913
  10. Diamond TW, Botha JR, Wing J, Meyers AM, Kalk WJ. Parathyroid hypertension. A reversible disorder. Arch Intern Med. 1986;146:1709–1712
  11. Taylor EN, Curhan GC, Forman JP. Parathyroid hormone and the risk of incident hypertension. J Hypertens. 2008;26:1390–1394
  12. Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, et al. Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up. J Clin Endocrinol Metab. 1997;82:106–112
  13. Bollerslev J, Jansson S, Mollerup CL, Nordenström J, Lundgren E, Tørring O, et al. Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective, randomized trial. J Clin Endocrinol Metab. 2007;92:1687–1692
  14. Hulter HN, Melby JC, Peterson JC, Cooke CR. Chronic continuous PTH infusion results in hypertension in normal patients. J Clin Hypertens. 1986;2:360–370
  15. Gennari C, Nami R, Bianchini C, Aversa AM. Blood pressure effects of acute hypercalcemia in normal patients and thyroparathyroidectomized patients. Miner Electrolyte Metab. 1985;11:369–373
  16. Kamycheva E, Jorde R, Haug E, Sager G, Sundsfjord J. Effects of acute hypercalcaemia on blood pressure in patients with and without parathyroid hormone secretion. Acta Physiol Scand. 2005;184:113–119
  17. Jespersen B, Randløv A, Abrahamsen J, Fogh-Andersen N, Kanstrup IL. Effects of PTH(1-34) on blood pressure, renal function, and hormones in essential hypertension: the altered pattern of reactivity may counteract raised blood pressure. Am J Hypertens. 1997;10:1356–1367
  18. Kovács L, Góth MI, Szabolcs I, Dohán O, Ferencz A, Szilágyi G. The effect of surgical treatment on secondary hyperaldosteronism and relative hyperinsulinemia in primary hyperparathyroidism. Eur J Endocrinol. 1998;138:543–547
  19. Gennari C, Nami R, Gonnelli S. Hypertension and primary hyperparathyroidism: the role of adrenergic and renin-angiotensin-aldosterone systems. Miner Electrolyte Metab. 1995;21:77–81
  20. Mazzocchi G, Aragona F, Malendowicz LK, Nussdorfer GG. PTH and PTH-related peptide enhance steroid secretion from human adrenocortical cells. Am J Physiol Endocrinol Metab. 2001;280:E209–E213
  21. Nilsson IL, Rastad J, Johansson K, Lind L. Endothelial vasodilatory function and blood pressure response to local and systemic hypercalcemia. Surgery. 2001;130:986–990
  22. Vlachakis ND, Frederics R, Valasquez M, Alexander N, Singer F, Maronde RF. Sympathetic system function and vascular reactivity in hypercalcemic patients. Hypertension. 1982;4:452–458
  23. Perkovic V, Hewitson TD, Kelynack KJ, Martic M, Tait MG, Becker GJ. Parathyroid hormone has a prosclerotic effect on vascular smooth muscle cells. Kidney Blood Press Res. 2003;26:27–33
  24. Smith JC, Page MD, John R, Wheeler MH, Cockcroft JR, Scanlon MF, et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab. 2000;85:3515–3519
  25. Kosch M, Hausberg M, Vormbrock K, Kisters K, Gabriels G, Rahn KH, et al. Impaired flow-mediated vasodilation of the brachial artery in patients with primary hyperparathyroidism improves after parathyroidectomy. Cardiovasc Res. 2000;47:813–818
  26. Judd SE, Nanes MS, Ziegler TR, Wilson PW, Tangpricha V. Optimal vitamin D status attenuates the age-associated increase in systolic blood pressure in white Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2008;87:136–141

 Supported by the National Institutes of Health Grant #NIIH K23AR054334.

PII: S0039-6060(09)00565-0

doi: 10.1016/j.surg.2009.09.024

Surgery
Volume 146, Issue 6 , Pages 1042-1047 , December 2009

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