Serum aldosterone is correlated positively to parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism.
BACKGROUND
Primary hyperparathyroidism is associated with an increased cardiovascular morbidity and mortality. However, mechanisms underlying this association are currently unclear. As there is clear evidence of the independent role of aldosterone on the cardiovascular system, the aim of this study was to evaluate aldosterone levels in patients with primary hyperparathyroidism.


METHODS
A prospective study of 134 consecutive patients with primary hyperparathyroidism before and 3 months after parathyroidectomy.


RESULTS
Pre-operative serum aldosterone and parathyroid hormone (PTH) levels were correlated positively in all patients (.238; P = .005). In the 62 patients (46%) that were not on antihypertensive medications, this correlation was stronger (.441; P = .0003). In the 72 patients (54%) treated with at least 1 antihypertensive medication, no correlation between preoperative aldosterone and PTH serum levels was observed. By multivariate analysis, pre-operative PTH level (.409; P = .005) was an independent predictor of aldosterone. Pre-operative PTH level >100 ng/L was an independent predictor of abnormally elevated plasma aldosterone level (odds ratio 3.5; P = .01). At 3 months after parathyroidectomy, no correlation was observed between postoperative PTH and aldosterone levels.


CONCLUSIONS
Aldosterone is correlated positively to preoperative PTH levels in patients with primary hyperparathyroidism. Aldosterone might be a key mediator of cardiovascular symptoms in patients with primary hyperparathyroidism.
Brunaud
Laurent
L
Department of General, Digestive and Endocrine Surgery, University of Nancy, Vandoeuvre-les-Nancy, France. l.brunaud@chu-nancy.fr
Germain
Adeline
A
Zarnegar
Rasa
R
Rancier
Marc
M
Alrasheedi
Saud
S
Caillard
Cecile
C
Ayav
Ahmet
A
Weryha
George
G
Mirallie
Eric
E
Bresler
Laurent
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D000959:Antihypertensive Agents; D010281:Parathyroid Hormone; D000450:Aldosterone; D002118:Calcium