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Arterial Hypertension, Metabolic Syndrome and Subclinical Cardiovascular Organ Damage in Patients with Asymptomatic Primary Hyperparathyroidism before and after Parathyroidectomy: Preliminary Results.

Luigi P, Chiara FM, Laura Z, Cristiano M, Giuseppina C, Luciano C, Giuseppe P, Sabrina C, Susanna S, Antonio C, Giuseppe C, Giorgio de T, Claudio L - Int J Endocrinol (2012)

Bottom Line: Results.PHPT showed an important myocardial and vascular remodelling.During follow-up in PHPT patients, we found significant reduction of prevalence of metabolic syndrome, blood pressure, and "non-dipping phenomenon." Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.

ABSTRACT
Background. Primary hyperparathyroidism (PHPT) is associated with high cardiovascular morbidity, and the role of calcium and parathyroid hormone is still controversial. Objective. To evaluate the prevalence and outcomes of metabolic syndrome, hypertension, and some cardiovascular alterations in asymptomatic PHPT, and specific changes after successful parathyroidectomy. Material and Methods. We examined 30 newly diagnosed PHPT patients (8 males, 22 females; mean age 56 ± 6 yrs), 30 patients with essential hypertension (EH) (9 males, 21 females; mean age 55 ± 4), and 30 normal subjects (NS) (9 males, 21 females: mean age 55 ± 6). All groups underwent evaluation with ambulatory monitoring blood pressure, echocardiography, and color-Doppler artery ultrasonography and were successively revaluated after one year from parathyroidectomy. Results. PHPT patients presented a higher prevalence of metabolic syndrome (38%) with respect to EH (28%). Prevalence of hypertension in PHPT was 81%, and 57% presented altered circadian rhythm of blood pressure, with respect to EH (35%) and NS (15%). PHPT showed an important myocardial and vascular remodelling. During follow-up in PHPT patients, we found significant reduction of prevalence of metabolic syndrome, blood pressure, and "non-dipping phenomenon." Conclusions. Cardiovascular and metabolic alterations should be considered as added parameters in evaluation of patients with asymptomatic PHPT.

No MeSH data available.


Related in: MedlinePlus

Linear correlation in PHPT patients between left atrium diameter (LAi) and bone mineral density (BMD) at lumbar spine (a) (r = −0.46; P < 0.01) and femoral neck (b) (r = −0.63; P < 0.001).
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fig4: Linear correlation in PHPT patients between left atrium diameter (LAi) and bone mineral density (BMD) at lumbar spine (a) (r = −0.46; P < 0.01) and femoral neck (b) (r = −0.63; P < 0.001).

Mentions: PHPT and EH patients showed an important cardiac remodeling compared to NS, such as significant increase of the IVSi (10.7 ± 0.9 mm and 11 ± 0.9 mm versus 8.8 ± 1.2 mm, resp.; P < 0.001), LVMi (182 ± 30.4 mm and 183 ± 63 mm versus 125 ± 26 mm, resp.; P < 0.001), and LAi (37.5 ± 3.5 mm and 39 ± 3.8 mm versus 20.8 ± 2.4 mm, resp.; P < 0.001) (Table 3). Moreover, 29.3% of PHPT patients showed a calcification of the aorta, and 28.5% had an altered release of the left ventricle (E/A < 1). In PHPT patients, we detected a significant negatively correlations between BMD at lumbar spine (L1–L4) and femoral neck (Fn) with the dimension of LAi (r = −0.46, P < 0.01; r = −0.63, P < 0.001, resp.) (Figure 4).


Arterial Hypertension, Metabolic Syndrome and Subclinical Cardiovascular Organ Damage in Patients with Asymptomatic Primary Hyperparathyroidism before and after Parathyroidectomy: Preliminary Results.

Luigi P, Chiara FM, Laura Z, Cristiano M, Giuseppina C, Luciano C, Giuseppe P, Sabrina C, Susanna S, Antonio C, Giuseppe C, Giorgio de T, Claudio L - Int J Endocrinol (2012)

Linear correlation in PHPT patients between left atrium diameter (LAi) and bone mineral density (BMD) at lumbar spine (a) (r = −0.46; P < 0.01) and femoral neck (b) (r = −0.63; P < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3375164&req=5

fig4: Linear correlation in PHPT patients between left atrium diameter (LAi) and bone mineral density (BMD) at lumbar spine (a) (r = −0.46; P < 0.01) and femoral neck (b) (r = −0.63; P < 0.001).
Mentions: PHPT and EH patients showed an important cardiac remodeling compared to NS, such as significant increase of the IVSi (10.7 ± 0.9 mm and 11 ± 0.9 mm versus 8.8 ± 1.2 mm, resp.; P < 0.001), LVMi (182 ± 30.4 mm and 183 ± 63 mm versus 125 ± 26 mm, resp.; P < 0.001), and LAi (37.5 ± 3.5 mm and 39 ± 3.8 mm versus 20.8 ± 2.4 mm, resp.; P < 0.001) (Table 3). Moreover, 29.3% of PHPT patients showed a calcification of the aorta, and 28.5% had an altered release of the left ventricle (E/A < 1). In PHPT patients, we detected a significant negatively correlations between BMD at lumbar spine (L1–L4) and femoral neck (Fn) with the dimension of LAi (r = −0.46, P < 0.01; r = −0.63, P < 0.001, resp.) (Figure 4).

Bottom Line: Results.PHPT showed an important myocardial and vascular remodelling.During follow-up in PHPT patients, we found significant reduction of prevalence of metabolic syndrome, blood pressure, and "non-dipping phenomenon." Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.

ABSTRACT
Background. Primary hyperparathyroidism (PHPT) is associated with high cardiovascular morbidity, and the role of calcium and parathyroid hormone is still controversial. Objective. To evaluate the prevalence and outcomes of metabolic syndrome, hypertension, and some cardiovascular alterations in asymptomatic PHPT, and specific changes after successful parathyroidectomy. Material and Methods. We examined 30 newly diagnosed PHPT patients (8 males, 22 females; mean age 56 ± 6 yrs), 30 patients with essential hypertension (EH) (9 males, 21 females; mean age 55 ± 4), and 30 normal subjects (NS) (9 males, 21 females: mean age 55 ± 6). All groups underwent evaluation with ambulatory monitoring blood pressure, echocardiography, and color-Doppler artery ultrasonography and were successively revaluated after one year from parathyroidectomy. Results. PHPT patients presented a higher prevalence of metabolic syndrome (38%) with respect to EH (28%). Prevalence of hypertension in PHPT was 81%, and 57% presented altered circadian rhythm of blood pressure, with respect to EH (35%) and NS (15%). PHPT showed an important myocardial and vascular remodelling. During follow-up in PHPT patients, we found significant reduction of prevalence of metabolic syndrome, blood pressure, and "non-dipping phenomenon." Conclusions. Cardiovascular and metabolic alterations should be considered as added parameters in evaluation of patients with asymptomatic PHPT.

No MeSH data available.


Related in: MedlinePlus