In a study on patients with hypertension and hyperparathyroidism (PTH> 65 pg / ml) of a large Californian cohort of patients, the Kaiser Permanente, there is a decrease in average blood pressure of 0.8 mm Hg at 2 years after parathyroidectomy in patients operated on for symptomatic primary hyperparathyroidism (n = 501), including hypertension. Above all, after surgery, there is a very significant decrease in the use of antihypertensive treatments and in the lower number of initiations of antihypertensive treatments. This study is published in JAMA Surgery.
Systemic disease
Primary hyperparathyroidism is now most often responsible for chronic complications, mainly renal and skeletal. Cardiovascular complications (hypertension, coronary disease, stroke, etc.) are widely suspected but not clearly defined in the current recommendations.
The indications for surgery during hyperparathyroidism according to current recommendations are only: young age, kidney damage, skeletal damage (lower bone densitometry and increased calcium levels in the blood (hypercalcemia).
A clear link with the cardiovascular system
Parathormone is thought to stimulate the renin-angiotensin system and vascular smooth musculature, which can lead to high blood pressure. However, until now, the link between parathyroidectomy and cardiovascular complications has been contradictory according to the studies.
In this beautiful study, this significant result on a significant number of patients is modest on average, but other studies had shown in small series, that surgery made it possible to lower the systolic and diastolic blood pressure by 10 mm Hg in patients hypertensive related to hyperparathyroidism.
This study suggests that, in hypertensive patients with hyperparathyroidism, parathyroidectomy may reduce blood pressure and the use of antihypertensive treatments, with the aim of reducing cardiovascular complications.
Interested in this topic ? Come and discuss it on our forum!
–
–
