Endocrine Abstracts

Background: Primary and secondary hyperparathyroidism (HP) are associated with increased risk for cardiovascular complications and high mortality. Risk factors correlated with hypertension in HP are hyperlipidemia, glucose intolerance, insulin resistance, vitamin D deficiency, etc. The aim of the study was to assess the incidence of cardiovascular complications in HP.

Material and methods: The study included 45 patients (15 men, 30 women), with a mean age of 45 years (range 21–65 years). Thirty-two patients were diagnosed with primary HP and 13 with secondary HP due to chronic kidney disease (stages 3 and 4). The patients were evaluated by biochemical, hormonal parameters, imagistic tests, and cardiac sonography.

Results: Vitamin D deficiency was documented in all patients with secondary HP and in 24 patients with primary HP (75%). Other metabolic disturbances and risk factors for cardiovascular diseases were as follows: diabetes mellitus (24.4%), smoking (28.8%), obesity (22.2%), and dyslipidemia (46.6%). The incidence of mitral and/or aortic valvular stenosis (caused by calcifications) was similar in the two groups, affecting 31.1% of the patients. Hypertension prevailed in the group of secondary HP (12 cases), as compared to primary HP (10 cases, P=0.0002, Fisher’s exact test). Peripheral atherosclerotic manifestations were noted in 11 cases (24.4%). Seven patients (15.5%) experienced an acute coronary event and three patients underwent PTCA procedures with stent implantation. Ten patients showed ventricular hypertrophy (22.2%); the incidence was similar in the two groups (eight patients with primary HP, respectively two with secondary HP).

Conclusion: Our study shows that hyperparathyroidism is associated with higher incidence of severe cardiovascular complications, occurring at younger ages as compared to general populations.