Background
Primary hyperparathyroidism is associated with an increased cardiovascular morbidity
and mortality. However, mechanisms underlying this association are currently unclear.
As there is clear evidence of the independent role of aldosterone on the cardiovascular
system, the aim of this study was to evaluate aldosterone levels in patients with
primary hyperparathyroidism.
Methods
A prospective study of 134 consecutive patients with primary hyperparathyroidism before
and 3 months after parathyroidectomy.
Results
Pre-operative serum aldosterone and parathyroid hormone (PTH) levels were correlated
positively in all patients (.238; P = .005). In the 62 patients (46%) that were not on antihypertensive medications,
this correlation was stronger (.441; P = .0003). In the 72 patients (54%) treated with at least 1 antihypertensive medication,
no correlation between preoperative aldosterone and PTH serum levels was observed.
By multivariate analysis, pre-operative PTH level (.409; P = .005) was an independent predictor of aldosterone. Pre-operative PTH level >100
ng/L was an independent predictor of abnormally elevated plasma aldosterone level
(odds ratio 3.5; P = .01). At 3 months after parathyroidectomy, no correlation was observed between
postoperative PTH and aldosterone levels.
Conclusion
Aldosterone is correlated positively to preoperative PTH levels in patients with primary
hyperparathyroidism. Aldosterone might be a key mediator of cardiovascular symptoms
in patients with primary hyperparathyroidism.
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Article info
Publication history
Accepted:
September 17,
2009
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
