Hormone, calcium and blood pressure relationships in primary hyperparathyroidism

The cause of hypertension in primary hyperparathyroidism and its response to corrective surgery remains a matter of controversy. We therefore studied blood pressure, vasoactive hormones and plasma calcium responses to parathyroidectomy in six hypertensive and two normotensive patients with primary h...

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Veröffentlicht in:Journal of hypertension 1988-09, Vol.6 (9), p.747-752
Hauptverfasser: Richards, A Mark, Espiner, Eric A, Nicholls, M Gary, Ikram, Hamid, Hamilton, Eric J, Maslowski, Andrew H
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container_end_page 752
container_issue 9
container_start_page 747
container_title Journal of hypertension
container_volume 6
creator Richards, A Mark
Espiner, Eric A
Nicholls, M Gary
Ikram, Hamid
Hamilton, Eric J
Maslowski, Andrew H
description The cause of hypertension in primary hyperparathyroidism and its response to corrective surgery remains a matter of controversy. We therefore studied blood pressure, vasoactive hormones and plasma calcium responses to parathyroidectomy in six hypertensive and two normotensive patients with primary hyperparathyroidism. Twenty-four-hour intra-arterial pressure recordings, together with hourly blood sampling for plasma renin activity (PRA), aldosterone, cortisol, catecholamines and calcium levels, were undertaken in each patient before surgery and were repeated under identical conditions 3–6 months after parathyroidectomy. Mean plasma calcium was 3.03 ± 0.1 before, and 2.35 ± 0.02 mmol/l after, parathyroidectomy. Changes in arterial pressure were small and variable in individual patients. Group mean arterial pressures before and after surgery were identical. Plasma cortisol and PRA were significantly higher in the hypercalcaemic state (P
doi_str_mv 10.1097/00004872-198809000-00009
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We therefore studied blood pressure, vasoactive hormones and plasma calcium responses to parathyroidectomy in six hypertensive and two normotensive patients with primary hyperparathyroidism. Twenty-four-hour intra-arterial pressure recordings, together with hourly blood sampling for plasma renin activity (PRA), aldosterone, cortisol, catecholamines and calcium levels, were undertaken in each patient before surgery and were repeated under identical conditions 3–6 months after parathyroidectomy. Mean plasma calcium was 3.03 ± 0.1 before, and 2.35 ± 0.02 mmol/l after, parathyroidectomy. Changes in arterial pressure were small and variable in individual patients. Group mean arterial pressures before and after surgery were identical. Plasma cortisol and PRA were significantly higher in the hypercalcaemic state (P&lt;0.01 and P&lt;0.05, respectively) but there was no significant difference in plasma aldosterone or catecholamine levels. No correlations between changes in plasma calcium or parathyroid hormone levels and concomitant changes in plasma concentration of other hormones were observed. Our findings show that correction of primary hyperparathyroidism has no systematic effect on arterial pressure in a heterogeneous group, including some patients with probable background essential hypertension, when evaluated 3-6 months after surgery. Compared with values after corrective surgery, mean levels of PRA and cortisol – but not aldosterone or catecholamines—are elevated in patients with primary hyperparathyroidism. These findings are consistent with an inhibitory effect of raised ionic calcium concentration on the response of the adrenal glomerulosa to angiotensin and adrenocorticotrophic hormone.</description><identifier>ISSN: 0263-6352</identifier><identifier>EISSN: 1473-5598</identifier><identifier>DOI: 10.1097/00004872-198809000-00009</identifier><identifier>PMID: 3053896</identifier><identifier>CODEN: JOHYD3</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott-Raven Publishers</publisher><subject>Aged ; Aldosterone - blood ; Biological and medical sciences ; Catecholamines - blood ; Endocrinopathies ; Female ; Hormones - blood ; Humans ; Hypercalcemia - complications ; Hyperparathyroidism - blood ; Hyperparathyroidism - complications ; Hyperparathyroidism - surgery ; Hypertension - complications ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Parathyroids. Parafollicular cells. Cholecalciferol. 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We therefore studied blood pressure, vasoactive hormones and plasma calcium responses to parathyroidectomy in six hypertensive and two normotensive patients with primary hyperparathyroidism. Twenty-four-hour intra-arterial pressure recordings, together with hourly blood sampling for plasma renin activity (PRA), aldosterone, cortisol, catecholamines and calcium levels, were undertaken in each patient before surgery and were repeated under identical conditions 3–6 months after parathyroidectomy. Mean plasma calcium was 3.03 ± 0.1 before, and 2.35 ± 0.02 mmol/l after, parathyroidectomy. Changes in arterial pressure were small and variable in individual patients. Group mean arterial pressures before and after surgery were identical. Plasma cortisol and PRA were significantly higher in the hypercalcaemic state (P&lt;0.01 and P&lt;0.05, respectively) but there was no significant difference in plasma aldosterone or catecholamine levels. No correlations between changes in plasma calcium or parathyroid hormone levels and concomitant changes in plasma concentration of other hormones were observed. Our findings show that correction of primary hyperparathyroidism has no systematic effect on arterial pressure in a heterogeneous group, including some patients with probable background essential hypertension, when evaluated 3-6 months after surgery. Compared with values after corrective surgery, mean levels of PRA and cortisol – but not aldosterone or catecholamines—are elevated in patients with primary hyperparathyroidism. These findings are consistent with an inhibitory effect of raised ionic calcium concentration on the response of the adrenal glomerulosa to angiotensin and adrenocorticotrophic hormone.</description><subject>Aged</subject><subject>Aldosterone - blood</subject><subject>Biological and medical sciences</subject><subject>Catecholamines - blood</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Hormones - blood</subject><subject>Humans</subject><subject>Hypercalcemia - complications</subject><subject>Hyperparathyroidism - blood</subject><subject>Hyperparathyroidism - complications</subject><subject>Hyperparathyroidism - surgery</subject><subject>Hypertension - complications</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parathyroids. Parafollicular cells. Cholecalciferol. 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Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)</topic><topic>Renin - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Richards, A Mark</creatorcontrib><creatorcontrib>Espiner, Eric A</creatorcontrib><creatorcontrib>Nicholls, M Gary</creatorcontrib><creatorcontrib>Ikram, Hamid</creatorcontrib><creatorcontrib>Hamilton, Eric J</creatorcontrib><creatorcontrib>Maslowski, Andrew H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Richards, A Mark</au><au>Espiner, Eric A</au><au>Nicholls, M Gary</au><au>Ikram, Hamid</au><au>Hamilton, Eric J</au><au>Maslowski, Andrew H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hormone, calcium and blood pressure relationships in primary hyperparathyroidism</atitle><jtitle>Journal of hypertension</jtitle><addtitle>J Hypertens</addtitle><date>1988-09</date><risdate>1988</risdate><volume>6</volume><issue>9</issue><spage>747</spage><epage>752</epage><pages>747-752</pages><issn>0263-6352</issn><eissn>1473-5598</eissn><coden>JOHYD3</coden><abstract>The cause of hypertension in primary hyperparathyroidism and its response to corrective surgery remains a matter of controversy. We therefore studied blood pressure, vasoactive hormones and plasma calcium responses to parathyroidectomy in six hypertensive and two normotensive patients with primary hyperparathyroidism. Twenty-four-hour intra-arterial pressure recordings, together with hourly blood sampling for plasma renin activity (PRA), aldosterone, cortisol, catecholamines and calcium levels, were undertaken in each patient before surgery and were repeated under identical conditions 3–6 months after parathyroidectomy. Mean plasma calcium was 3.03 ± 0.1 before, and 2.35 ± 0.02 mmol/l after, parathyroidectomy. Changes in arterial pressure were small and variable in individual patients. Group mean arterial pressures before and after surgery were identical. Plasma cortisol and PRA were significantly higher in the hypercalcaemic state (P&lt;0.01 and P&lt;0.05, respectively) but there was no significant difference in plasma aldosterone or catecholamine levels. No correlations between changes in plasma calcium or parathyroid hormone levels and concomitant changes in plasma concentration of other hormones were observed. Our findings show that correction of primary hyperparathyroidism has no systematic effect on arterial pressure in a heterogeneous group, including some patients with probable background essential hypertension, when evaluated 3-6 months after surgery. Compared with values after corrective surgery, mean levels of PRA and cortisol – but not aldosterone or catecholamines—are elevated in patients with primary hyperparathyroidism. These findings are consistent with an inhibitory effect of raised ionic calcium concentration on the response of the adrenal glomerulosa to angiotensin and adrenocorticotrophic hormone.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott-Raven Publishers</pub><pmid>3053896</pmid><doi>10.1097/00004872-198809000-00009</doi><tpages>6</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete
subjects Aged
Aldosterone - blood
Biological and medical sciences
Catecholamines - blood
Endocrinopathies
Female
Hormones - blood
Humans
Hypercalcemia - complications
Hyperparathyroidism - blood
Hyperparathyroidism - complications
Hyperparathyroidism - surgery
Hypertension - complications
Male
Malignant tumors
Medical sciences
Middle Aged
Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
Renin - blood
title Hormone, calcium and blood pressure relationships in primary hyperparathyroidism
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