PHPT: does parathyroidectomy reduce CVD risk?

  • Ejlsmark-Svensson H & al.
  • J Clin Endocrinol Metab
  • 12 Mar 2019

  • International Clinical Digest
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Takeaway

  • Results from a small randomized clinical trial (RCT) suggest that parathyroidectomy is associated with reduced total cholesterol levels, but increased ambulatory diastolic blood pressure in patients with primary hyperparathyroidism (PHPT).

Why this matters

  • Associations between primary hyperthyroidism, thyroidectomy, and CVD risk have varied in previous studies.

Key results

  • Plasma total cholesterol levels were reduced in patients who received parathyroidectomy compared with control patients (−0.24% vs +5.25%; P=.04).
  • 24-hour diastolic blood pressure was increased in patients who received parathyroidectomy compared with control patients (+0.51% vs −3.40; P=.03).
  • Parathyroidectomy was significantly associated with decreased pulse wave velocity (a marker for arterial stiffness) compared with no parathyroidectomy in patients with ionized calcium ≥1.45 mmol/L (−4.4% vs +3.0%; P=.02), but not in the entire group (P>.05).

Study design

  • 79 patients with primary hyperparathyroidism, 40 who received parathyroidectomy and 39 control subjects, were included.
  • Funding: None.

Limitations

  • Small patient sample size.
  • Patients with severe hypercalcemia excluded.
  • Short follow-up.

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