Abstract
OBJECTIVES: The high prevalence of arterial hypertension in primary hyperparathyroidism (pHPT) is largely unexplained. Apart from parathyroid hormone (PTH), the mineral hormones fibroblast growth factor (FGF)-23 and aldosterone-to-renin ratio (ARR) are upregulated in pHPT. We aimed to determine whether nocturnal blood pressure (BP) is related with PTH, FGF-23 or ARR in a relatively large sample of pHPT patients.
METHODS: Cross-sectional data of the single-center "Eplerenone in Primary Hyperparathyroidism" trial were used. All patients with a biochemical diagnosis of pHPT who had both available 24-h ambulatory BP monitoring and valid laboratory data were included.
RESULTS: Full data were available in 136 patients (mean age 67 ± 10 years, 78% women). Median PTH was 99 (interquartile range: 82-124) pg/ml and mean calcium was 2.63 ± 0.15 mmol/l. ARR, but not PTH or FGF-23, was significantly and directly related with nocturnal SBP (Pearson's r = 0.241, P < 0.01) and DBP (r = 0.328, P < 0.01). In multivariate regression analyses, with adjustment for age, sex, PTH, FGF-23, traditional cardiovascular risk factors, antihypertensive medication and parameters of calcium metabolism ARR remained significantly and directly related with nocturnal BP (SBP: adjusted β-coefficient = 0.289, P < 0.01; DBP: β = 0.399, P < 0.01). The relationship between ARR and nocturnal SBP was exclusively present in patients with PTH levels above the median of 99 pg/ml.
CONCLUSION: ARR, but not FGF-23 or PTH, was independently and directly related with nocturnal BP parameters in patients with pHPT, and this relationship was dependent on pHPT disease severity. Inappropriately, elevated aldosterone may partially explain the high prevalence of arterial hypertension in pHPT.
| Original language | English |
|---|---|
| Pages (from-to) | 1778-1786 |
| Number of pages | 9 |
| Journal | Journal of Hypertension |
| Volume | 34 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sep 2016 |
Cite this
}
Parathyroid hormone, aldosterone-to-renin ratio and fibroblast growth factor-23 as determinants of nocturnal blood pressure in primary hyperparathyroidism : the eplerenone in primary hyperparathyroidism trial. / Verheyen, N.; Fahrleitner-Pammer, A.; Pieske, B.; Meinitzer, A.; Belyavskiy, E.; Wetzel, J.; Gaksch, M.; Grubler, M.R.; Catena, C.; Sechi, L. A.; van Ballegooijen, Adriana J.; Brandenburg, Vincent M.; Scharnagl, H.; Perl, S.; Brussee, H.; Marz, W.; Pilz, S.; Tomaschitz, A.
In: Journal of Hypertension, Vol. 34, No. 9, 09.2016, p. 1778-1786.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Parathyroid hormone, aldosterone-to-renin ratio and fibroblast growth factor-23 as determinants of nocturnal blood pressure in primary hyperparathyroidism
T2 - the eplerenone in primary hyperparathyroidism trial
AU - Verheyen, N.
AU - Fahrleitner-Pammer, A.
AU - Pieske, B.
AU - Meinitzer, A.
AU - Belyavskiy, E.
AU - Wetzel, J.
AU - Gaksch, M.
AU - Grubler, M.R.
AU - Catena, C.
AU - Sechi, L. A.
AU - van Ballegooijen, Adriana J.
AU - Brandenburg, Vincent M.
AU - Scharnagl, H.
AU - Perl, S.
AU - Brussee, H.
AU - Marz, W.
AU - Pilz, S.
AU - Tomaschitz, A.
N1 - M1 - 9 ISI Document Delivery No.: DS6CX Times Cited: 0 Cited Reference Count: 44 Verheyen, Nicolas Fahrleitner-Pammer, Astrid Pieske, Burkert Meinitzer, Andreas Belyavskiy, Evgeny Wetzel, Julia Gaksch, Martin Gruebler, Martin R. Catena, Cristiana Sechi, Leonardo A. Van Ballegooijen, Adriana J. Brandenburg, Vincent M. Scharnagl, Hubert Perl, Sabine Brussee, Helmut Maerz, Winfried Pilz, Stefan Tomaschitz, Andreas Catena, Cristiana/0000-0001-5039-435X; Grubler, Martin R./0000-0002-1761-2914 Austrian National Bank (Jubilaeumsfond) [14621, 13878 AU5, 13905]; Austrian Society of Bone and Mineral Research (OEGKM) N.V. was supported by funding of the Austrian National Bank (Jubilaeumsfond: project number 14621) and by the Austrian Society of Bone and Mineral Research (OEGKM, Felix-Bronner Grant 2014). M.G. was supported by funding of the Austrian National Bank (Jubilaeumsfond: project numbers 13878 AU5 and 13905). 0 1 LIPPINCOTT WILLIAMS & WILKINS PHILADELPHIA J HYPERTENS
PY - 2016/9
Y1 - 2016/9
N2 - OBJECTIVES: The high prevalence of arterial hypertension in primary hyperparathyroidism (pHPT) is largely unexplained. Apart from parathyroid hormone (PTH), the mineral hormones fibroblast growth factor (FGF)-23 and aldosterone-to-renin ratio (ARR) are upregulated in pHPT. We aimed to determine whether nocturnal blood pressure (BP) is related with PTH, FGF-23 or ARR in a relatively large sample of pHPT patients.METHODS: Cross-sectional data of the single-center "Eplerenone in Primary Hyperparathyroidism" trial were used. All patients with a biochemical diagnosis of pHPT who had both available 24-h ambulatory BP monitoring and valid laboratory data were included.RESULTS: Full data were available in 136 patients (mean age 67 ± 10 years, 78% women). Median PTH was 99 (interquartile range: 82-124) pg/ml and mean calcium was 2.63 ± 0.15 mmol/l. ARR, but not PTH or FGF-23, was significantly and directly related with nocturnal SBP (Pearson's r = 0.241, P < 0.01) and DBP (r = 0.328, P < 0.01). In multivariate regression analyses, with adjustment for age, sex, PTH, FGF-23, traditional cardiovascular risk factors, antihypertensive medication and parameters of calcium metabolism ARR remained significantly and directly related with nocturnal BP (SBP: adjusted β-coefficient = 0.289, P < 0.01; DBP: β = 0.399, P < 0.01). The relationship between ARR and nocturnal SBP was exclusively present in patients with PTH levels above the median of 99 pg/ml.CONCLUSION: ARR, but not FGF-23 or PTH, was independently and directly related with nocturnal BP parameters in patients with pHPT, and this relationship was dependent on pHPT disease severity. Inappropriately, elevated aldosterone may partially explain the high prevalence of arterial hypertension in pHPT.
AB - OBJECTIVES: The high prevalence of arterial hypertension in primary hyperparathyroidism (pHPT) is largely unexplained. Apart from parathyroid hormone (PTH), the mineral hormones fibroblast growth factor (FGF)-23 and aldosterone-to-renin ratio (ARR) are upregulated in pHPT. We aimed to determine whether nocturnal blood pressure (BP) is related with PTH, FGF-23 or ARR in a relatively large sample of pHPT patients.METHODS: Cross-sectional data of the single-center "Eplerenone in Primary Hyperparathyroidism" trial were used. All patients with a biochemical diagnosis of pHPT who had both available 24-h ambulatory BP monitoring and valid laboratory data were included.RESULTS: Full data were available in 136 patients (mean age 67 ± 10 years, 78% women). Median PTH was 99 (interquartile range: 82-124) pg/ml and mean calcium was 2.63 ± 0.15 mmol/l. ARR, but not PTH or FGF-23, was significantly and directly related with nocturnal SBP (Pearson's r = 0.241, P < 0.01) and DBP (r = 0.328, P < 0.01). In multivariate regression analyses, with adjustment for age, sex, PTH, FGF-23, traditional cardiovascular risk factors, antihypertensive medication and parameters of calcium metabolism ARR remained significantly and directly related with nocturnal BP (SBP: adjusted β-coefficient = 0.289, P < 0.01; DBP: β = 0.399, P < 0.01). The relationship between ARR and nocturnal SBP was exclusively present in patients with PTH levels above the median of 99 pg/ml.CONCLUSION: ARR, but not FGF-23 or PTH, was independently and directly related with nocturnal BP parameters in patients with pHPT, and this relationship was dependent on pHPT disease severity. Inappropriately, elevated aldosterone may partially explain the high prevalence of arterial hypertension in pHPT.
KW - Aged
KW - Aldosterone/blood
KW - Antihypertensive Agents/therapeutic use
KW - Blood Pressure
KW - Blood Pressure Monitoring, Ambulatory
KW - Calcium/blood
KW - Circadian Rhythm
KW - Cross-Sectional Studies
KW - Diastole
KW - Female
KW - Fibroblast Growth Factors/blood
KW - Humans
KW - Hyperparathyroidism, Primary/blood
KW - Hypertension/blood
KW - Male
KW - Middle Aged
KW - Mineralocorticoid Receptor Antagonists/therapeutic use
KW - Parathyroid Hormone/blood
KW - Randomized Controlled Trials as Topic
KW - Renin/blood
KW - Risk Factors
KW - Sex Factors
KW - Spironolactone/analogs & derivatives
KW - Systole
U2 - 10.1097/hjh.0000000000001004
DO - 10.1097/hjh.0000000000001004
M3 - Article
VL - 34
SP - 1778
EP - 1786
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 9
ER -