title: Parathyroid hormone and calcium are independently associated with subclinical vascular disease in a community-based cohort.
abstract: OBJECTIVE
  Diseases with abnormal levels of parathyroid hormone (PTH) and calcium, such as primary and secondary hyperparathyroidism, are associated with an increased risk of cardiovascular morbidity and mortality. However, there is paucity on the association between calcium, PTH and abnormalities in the vascular system in the general population.
  
  
  METHODS
  In the PIVUS study (Prospective Investigation of the Vasculature in Uppsala Seniors), a community based cohort of 70-year old men and women (n = 1016), the associations between s-calcium, p-PTH and endothelial function, arterial stiffness and blood pressures were investigated, adjusting for cardiovascular risk factors and mineral metabolism.
  
  
  RESULTS
  In multivariable linear regression models 1 SD increase in calcium was associated with 1.1 units decrease in the stroke volume/pulse pressure ratio and 0.06 decrease in common carotid artery distensibility (p < 0.001) indicative of increased arterial stiffness. Further, calcium was associated with increasing calculated central pulse pressure with 1.3 mmHg elevation per 1 SD increase in calcium (p < 0.05). 1 SD increase in PTH was associated with 1.9 and 1.0 mmHg increase in intra-arterially measured brachial artery systolic and diastolic blood pressures, respectively (p < 0.01), as well as 1.6 and 0.9 mmHg increase in calculated central systolic and diastolic blood pressures (p < 0.05). PTH was not associated with arterial stiffness, endothelial function or pulse pressure.
  
  
  CONCLUSIONS
  In a large community-based sample of elderly, calcium was independently associated with increased arterial stiffness, and PTH independently to intra-arterial peripheral and calculated central blood pressures. The findings indicate a possible link between the vasculature and mineral metabolism.
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden. Electronic address: emil.hagstrom@ucr.uu.se.
authors.forename: Emil
authors.initials: E
authors.lastname: Hagström
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Surgery, Central Hospital, Västerås, Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Ahlström
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Ärnlöv
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Melhus
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Hellman
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
mesh_terms: D000367:Age Factors; D000368:Aged; D062186:Arterial Pressure; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden; D014652:Vascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D002118:Calcium
keywords: Blood pressure; Calcium; Parathyroid hormone; Vascular function; Vascular stiffness