title: Parathyroid hormone and cardiovascular disease events: A systematic review and meta-analysis of prospective studies.
abstract: BACKGROUND
  Parathyroid hormone (PTH) excess might play a role in cardiovascular health. We therefore conducted a systematic review and meta-analysis to evaluate the association between PTH and cardiovascular disease (CVD) events, and intermediate outcomes.
  
  
  METHODS
  We conducted a systematic and comprehensive database search using MEDLINE and Embase between 1947 and October 2012. We included English-language prospective studies that reported risk estimates for PTH and CVD events, and intermediate outcomes. The characteristics of study populations, exposure, and outcomes of total CVD events, fatal and non-fatal CVD events were reported, and a quality assessment was conducted. Results were extracted for the highest versus lowest PTH concentrations, and meta-analyses were carried out using random effects models.
  
  
  RESULTS
  The systematic literature search yielded 5770 articles, and 15 studies were included. Study duration ranged between 2 and 14 years. All studies were performed primarily in whites with a mean age between 55 and 75 years. The meta-analyses included 12 studies, of which 10 investigated total CVD events; 7, fatal CVD events; and 3, non-fatal CVD events. PTH excess indicated an increased risk for total CVD events: pooled HR (95% CI), 1.45 (1.24-1.71). The results for fatal CVD events and non-fatal CVD events were: HR 1.50 (1.18-1.91) and HR 1.48 (1.14-1.92). Heterogeneity was moderately present; however, sensitivity analyses for follow-up duration, prior CVD, or PTH as dichotomous values showed similar results.
  
  
  CONCLUSIONS
  The meta-analysis indicates that higher PTH concentrations are associated with increased risk of CVD events.
authors.affiliation: Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, The Netherlands. hanne.van.ballegooijen@vu.nl
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: van Ballegooijen
authors.forename: Ilse
authors.initials: I
authors.lastname: Reinders
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Ingeborg A
authors.initials: IA
authors.lastname: Brouwer
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D009017:Morbidity; D010281:Parathyroid Hormone / Q000502:physiology*; D012307:Risk Factors
chemical_list: D010281:Parathyroid Hormone