Symeon Tournis*, Konstantinos Makris, Etienne Cavalier and George Trovas Pages 5628 - 5636 ( 9 )
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.
Primary hyperparathyroidism, cardiovascular disease, calcium, parathyroid hormone, hypertension, parathyroidectomy.
Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, KAT Hospital, Athens, Clinical Biochemistry Department, KAT General Hospital, Athens, Department of Clinical Chemistry, University of Liege, CHU Sart-Tilman, Domaine du Sart-Tilman, B-4000, Liege, Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, KAT Hospital, Athens