TY - JOUR
T1 - Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism
T2 - The EPATH trial
AU - Wetzel, Julia
AU - Pilz, Stefan
AU - Grübler, Martin R.
AU - Fahrleitner-Pammer, Astrid
AU - Dimai, Hans P.
AU - von Lewinski, Dirk
AU - Kolesnik, Ewald
AU - Perl, Sabine
AU - Trummer, Christian
AU - Schwetz, Verena
AU - Meinitzer, Andreas
AU - Belyavskiy, Evgeny
AU - Völkl, Jakob
AU - Catena, Cristiana
AU - Brandenburg, Vincent
AU - März, Winfried
AU - Pieske, Burkert
AU - Brussee, Helmut
AU - Tomaschitz, Andreas
AU - Verheyen, Nicolas D.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Patients with primary hyperparathyroidism are at increased risk for high blood pressure, vascular stiffening, and left ventricular hypertrophy, but previous studies have failed to demonstrate the direct associations with circulating parathyroid hormone (PTH) levels. The authors investigated cross-sectional relationships between PTH and 24-hour pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index in patients with primary hyperparathyroidism who were treatment-naive with cinacalcet, renin-angiotensin-aldosterone-system inhibitors, and thiazide or loop diuretics. In 76 patients, mean±SD of pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index values were 9.3±1.8 m/s, 116.6±17.0 mm Hg, and 92.8±23.0 g/m². In multivariate linear regression analyses with adjustment for potentially confounding parameters, PTH was independently associated with nocturnal systolic blood pressure (adjusted ß coefficient=.284, P=.040), mean 24-hour pulse wave velocity (ß=.199, P=.001), and left ventricular mass index (ß=.252, P=.025). PTH may promote vascular and cardiac remodeling in primary hyperparathyroidism. Interventional trials are needed to test the antihypertensive and cardioprotective effects of PTH-inhibitory treatment strategies.
AB - Patients with primary hyperparathyroidism are at increased risk for high blood pressure, vascular stiffening, and left ventricular hypertrophy, but previous studies have failed to demonstrate the direct associations with circulating parathyroid hormone (PTH) levels. The authors investigated cross-sectional relationships between PTH and 24-hour pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index in patients with primary hyperparathyroidism who were treatment-naive with cinacalcet, renin-angiotensin-aldosterone-system inhibitors, and thiazide or loop diuretics. In 76 patients, mean±SD of pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index values were 9.3±1.8 m/s, 116.6±17.0 mm Hg, and 92.8±23.0 g/m². In multivariate linear regression analyses with adjustment for potentially confounding parameters, PTH was independently associated with nocturnal systolic blood pressure (adjusted ß coefficient=.284, P=.040), mean 24-hour pulse wave velocity (ß=.199, P=.001), and left ventricular mass index (ß=.252, P=.025). PTH may promote vascular and cardiac remodeling in primary hyperparathyroidism. Interventional trials are needed to test the antihypertensive and cardioprotective effects of PTH-inhibitory treatment strategies.
KW - ambulatory blood pressure monitoring
KW - blood pressure
KW - left ventricular mass
KW - parathyroid hormone
KW - primary hyperparathyroidism
KW - pulse wave velocity
UR - http://www.scopus.com/inward/record.url?scp=85027857990&partnerID=8YFLogxK
U2 - 10.1111/jch.13064
DO - 10.1111/jch.13064
M3 - Article
C2 - 28834128
AN - SCOPUS:85027857990
VL - 19
SP - 1173
EP - 1180
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
SN - 1524-6175
IS - 11
ER -