Document Detail

Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcemia followed up for 25 years.
MedLine Citation:
PMID:  11742326     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The natural history of mild hyperparathyroidism is incompletely clarified. METHODS: Consistent hypercalcemia was found in 172 patients (aged 28-86 years) participating in population-based screenings in both 1969 and 1971. Mortality until 1994 was compared with 344 matched, normocalcemic controls from the study population. Altogether, 55 case-control pairs underwent biochemical analysis in 1992, whereas 86 patients had died, 8 were lost to follow-up, and 23 had undergone parathyroid operation. RESULTS: Mortality was higher (P = .015) in patients younger than 70 years. Cardiovascular diseases were over-represented causes of death. The hazard ratio for hypercalcemia as an independent cause of cardiovascular mortality was 1.72 (95% CI, 1.24-2.37; P < .001). The initially mild hypercalcemia in patients (2.67 +/- 0.07 mmol/L) decreased over time (P = .0001), whereas the serum calcium value remained constant in the controls. Serum calcium and serum parathyroid hormone values in patients were higher than controls at the follow-up (P < .0001, .01, respectively). All but 17 patients were normocalcemic in 1992, and only 2 (1.4%) developed a serum calcium value higher than 3 mmol/L. CONCLUSIONS: Mild hypercalcemia in patients followed up for more than 2 decades is accompanied by premature cardiovascular death despite trends to spontaneous resolution. The principal cause of hypercalcemia probably is primary hyperparathyroidism, but mechanisms contributing to its regression over time are speculative.
E Lundgren; L Lind; M Palmér; S Jakobsson; S Ljunghall; J Rastad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  130     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-19     Completed Date:  2002-01-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  978-85     Citation Subset:  AIM; IM    
Department of Surgery, University Hospital, Uppsala, Sweden.
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MeSH Terms
Aged, 80 and over
Calcium / blood*
Cardiovascular Diseases / mortality*
Follow-Up Studies
Hypercalcemia / blood*,  mortality
Hyperparathyroidism / complications*
Middle Aged
Proportional Hazards Models
Prospective Studies
Survival Rate
Reg. No./Substance:

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