Parathyroidectomy decreases systolic and diastolic blood pressure in hypertensive patients with primary hyperparathyroidism

BackgroundPrimary hyperparathyroidism (PHPT) is associated with an increased risk of cardiovascular disease, including hypertension. The purpose of this study was to determine the effect of parathyroidectomy on systolic and diastolic blood pressures (BP) in hypertensive patients with PHPT.MethodsA retrospective review of medical records was performed in 368 patients undergoing parathyroidectomy and 96 patients undergoing thyroidectomy by a single surgeon. We evaluated changes in serum calcium, parathyroid hormone (PTH), and BP before and 6 months after surgery.ResultsIn patients undergoing parathyroidectomy with hypertension (n = 147), a significant decrease in both systolic and diastolic BP was observed; systolic BP decreased from 152.5 ± 10.5 to 140.3 ± 16.2 mmHg (P < .001) and diastolic BP decreased from 94.5 ± 6.8 to 81.7 ± 10.3 mmHg (P < .001). In these patients, PTH decreased from 136 ± 186 to 58.7 ± 44.3 pg/mL (P < .001) and serum calcium decreased from 11.1 ± 0.6 to 9.5 ± 0.7 mg/dL (P < .001). In patients undergoing parathyroidectomy without hypertension (n = 145) and thyroidectomy alone (n = 96), no significant change in systolic or diastolic BP was observed.ConclusionParathyroidectomy in hypertensive patients seems to reduce both systolic and diastolic BP . The mechanisms responsible for this effect are unknown and deserve further study.