title: Primary hyperparathyroidism predicts hypertension: Results from the National Inpatient Sample.
abstract: BACKGROUND
  Primary hyperparathyroidism (pHPT), most commonly caused by solitary parathyroid adenomas, leads to mobilization of calcium and is known to result in nephrolithiasis and osteoporosis. To date, studies of pHPT and cardiovascular risk factors and events have produced discrepant findings, likely due to small sample sizes and enrolling populations with varying disease severity.
  
  
  OBJECTIVE
  We utilized a national registry, hypothesizing an association between pHPT and cardiovascular risk factors and events.
  
  
  METHODS
  Patients >18years with a diagnosis of pHPT were identified in the Nationwide Inpatient Sample 2009-2010 database using the Ninth Revision of International Classification of Diseases code 252.01. Demographics, risk factors, and cardiovascular event rates were collected and compared to general population data.
  
  
  RESULTS
  pHPT was present in 0.1% (n=37,922) of hospital admissions. There was a significant increase in the prevalence of most cardiac risk factors including hypertension (HTN), diabetes mellitus, hyperlipidemia, obesity, and chronic kidney disease. The rates of heart failure (HF) and coronary artery disease (CAD) were higher in the pHPT population. However, after performing multivariate regression for age and cardiac risk factors, pHPT did not independently predict HF or CAD. The risk of HTN, however, was independently predicted by pHPT (OR 1.3; p<0.001).
  
  
  CONCLUSIONS
  Primary hyperparathyroidism independently predicted the risk of hypertension in a patient population from a large national database. Despite significant differences in univariate analysis of cardiac risk factors and events, pHPT did not independently predict risk of HF or CAD after multivariate regression analysis. Future studies should explore potential mechanisms relating hypertension to pHPT.
authors.affiliation: Einstein Medical Center, Cardiology Division, 5501 Old York Road, Levy 3232, Philadelphia, PA 19141, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kalla
authors.affiliation: Einstein Medical Center, Cardiology Division, 5501 Old York Road, Levy 3232, Philadelphia, PA 19141, USA.
authors.forename: P
authors.initials: P
authors.lastname: Krishnamoorthy
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gopalakrishnan
authors.affiliation: Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Garg
authors.affiliation: Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: N C
authors.initials: NC
authors.lastname: Patel
authors.affiliation: Einstein Medical Center, Cardiology Division, 5501 Old York Road, Levy 3232, Philadelphia, PA 19141, USA; Sidney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: figueredov@einstein.edu.
authors.forename: V M
authors.initials: VM
authors.lastname: Figueredo
mesh_terms: D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications*; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D014481:United States
keywords: Coronary artery disease; Heart failure; Hyperparathyroid; Hypertension