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Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism

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Abstract

Introduction

Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk.

Purpose

The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls.

Methods

Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h “weighted” Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements.

Results

Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively).

Conclusion

Systolic blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.

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Acknowledgements

This research did not receive any specific grant from any funding agency in the public commercial or non-profit section.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Specialties, University of Rome “La Sapienza”, Rome, Italy

    A. Concistrè, G. La Torre, L. Petramala, C. Marinelli & C. Letizia

  2. Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy

    A. Grillo

  3. Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy

    R. Carretta & B. Fabris

  4. Department of Medicine-DIMED, University of Padova, Padova, Italy

    A. Rebellato & F. Fallo

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  1. A. Concistrè
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Correspondence to C. Letizia.

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The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Concistrè, A., Grillo, A., La Torre, G. et al. Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism. Endocrine 60, 129–137 (2018). https://doi.org/10.1007/s12020-017-1362-x

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