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Large-artery stiffness: A reversible marker of cardiovascular risk in primary hyperparathyroidism.
MedLine Citation:
PMID:  21645899     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Patients with primary hyperparathyroidism (pHPT) are at increased risk of cardiovascular mortality. We investigated whether aortic stiffness, an early marker of arteriosclerosis and a strong predictor of cardiovascular risk, is increased in pHPT, and whether it improves after parathyroidectomy. METHODS: Twenty-four patients with mild pHPT (age 56±10 years, blood pressure 136/85mmHg, serum calcium 2.55-3.00mmol/L) and 48 control subjects individually matched with cases by age, sex and blood pressure underwent aortic (carotid-femoral) and upper-limb (carotid-radial) pulse wave velocity (PWV) determination by applanation tonometry in a case-control study. Subjects with renal disease, diabetes, treated hypertension or overt cardiovascular disease were excluded from the study. Seventeen of the patients with pHPT were re-examined 4 weeks after surgical parathyroidectomy. RESULTS: Aortic PWV was significantly higher among pHTP patients (11.4±2 vs 9.6±2m/s, p<0.001). In a conditional logistic regression analysis, pHPT was independently associated with an increased risk of having an aortic PWV >12m/s (odds ratio 3.28, 95% confidence interval 1.21-8.93). As expected, surgery was accompanied by a reduction in serum calcium (from 2.77±0.2 to 2.25±0.1mmol/L, p<0.001) and parathyroid hormone (from 29.6±10 to 3.3±2pmol/L, p<0.001). Aortic PWV decreased after surgery (from 10.9±2 to 9.8±2m/s, p=0.003). The change in aortic PWV remained significant also after adjustment for changes in blood pressure (p<0.01). Changes in upper-limb PWV generally paralleled those in aortic PWV. CONCLUSION: pHPT is associated with increased aortic stiffness, which improves after parathyroidectomy. Our data demonstrate that aortic stiffness may improve upon removal of hyperparathyroid stimuli.
Giuseppe Schillaci; Giacomo Pucci; Matteo Pirro; Massimo Monacelli; Anna Maria Scarponi; Maria Rosaria Manfredelli; Fabio Rondelli; Nicola Avenia; Elmo Mannarino
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-18
Journal Detail:
Title:  Atherosclerosis     Volume:  -     ISSN:  1879-1484     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-6-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy.
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