Improvement of Hypertension after Parathyroidectomy of Patients Suffering from Primary Hyperparathyroidism

Broulík, P; Broulíková, Alena; Adámek, S; Libánský, P; Tvrdon, J; Broulíková, Karolina; Kubinyi, Jozef

doi:10.1155/2011/309068

Cited by 48 publications

(41 citation statements)

References 27 publications

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“…Hypertension secondary to pHPT is still being debated [22] . The 54.1% incidence rate of hypertension in pHPT is within the range of 20-69% reported in various studies [5,23,24] . This large variation in reported incidence could be due to variations between different authors due to differences in blood pressure measurement criteria of hypertension and different patient characteristics.…”

Section: Discussionsupporting

confidence: 76%

Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism

et al. 2017

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Objective: To investigate the incidence and identify risk factors for the occurrence of intraoperative hypertension (IOH) during surgery for primary hyperparathyroidism (pHPT). Subjects and Methods: The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. IOH was defined as an increase in systolic blood pressure ≥20% compared to baseline values which lasted for 15 min. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on the American Society of Anesthesiologists [ASA] classification), comorbidities, type and duration of surgery, and duration of anesthesia on IOH occurrence. The investigated factors were obtained from the patients' medical history, anesthesia charts, and the daily practice database. Logistic regression analysis was done to determine the predictors of IOH. Results: Of the 269 patients, 153 (56.9%) had IOH. Based on the univariate analysis, age, body mass index, ASA status, duration of anesthesia, and preoperative hypertension were risk factors for the occurrence of IOH. Multivariate analysis showed that independent predictors of IOH were a history of hypertension (OR = 2.080, 95% CI: 1.102-3.925, p = 0.024) and age (OR = 0.569, 95% CI: 0.360-0.901, p = 0.016). Conclusion: In this study, a high percentage (56%) of the patients developed IOH during surgery for pHPT, which indicates that special attention should be paid to these patients, especially to the high-risk groups: older patients and those with a history of hypertension. Further, this study showed that advanced age and hypertension as a coexisting disease prior to parathyroid surgery were independent risk factors for the occurrence of IOH.

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Section: Discussionsupporting

confidence: 76%

Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism

et al. 2017

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“…It was slightly higher in females. This study has been drawn from our group of PHPT patients (Broulík et al, 2011).…”

Section: Resultsmentioning

confidence: 99%

Changes in the Pattern of Primary Hyperparathyroidism in Czech Republic

et al. 2015

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Broulík P.; Adámek S.; Libánský P.; Kubinyi J. Report / Vol. 116 (2015) No. 2, Changes in the Pattern of Primary Hyperparathyroidism in Czech Republic Key words: Primary hyperparathyroidism -Calcemia -Osteodystrophy -iPTHNefrolithiasis -Asymptomatic PHPT Abstract: Primary hyperparathyroidism (PHPT) is currently the most common endocrine disorder in Czech Republic after diabetes and thyroid diseases particularly in postmenopausal women. Over the past 40 years PHPT has changed from a rare severe disease of the bones and kidneys to common disease with hypertension, peptic ulcer, pancreatitis, easy fatigue and proximal muscle weakness. During 43 years we have examined one of the greatest groups of patients with PHPT. In the early 1970 the estimated incidence of PHPT in former Czechoslovakia was approximately 8 cases per 100 000 persons per year. Our data showed that the incidence of PHPT increased sharply to 24 cases per 100 000 persons per year in same community with the introduction of automated serum calcium and iPTH measurement. The disease is four times more frequent in women as in man. The ratio women to men did not changed since 1981. However the incidence of PHPT changed in Czech Republic from previous years, it develops around the fifth decade of life and is increasingly discovered with advancing age. The incidence of hypertension, diabetes mellitus, cholelithiasis, pancreatitis and peptic ulcer among patients with PHPT is higher as compared with the incidence of these diseases in the general population. However there are still patients suffering from bone and renal complication of PHPT. Removing the adenoma by an experienced surgeon is the first choice of treatment of patients with PHPT. The study offers valuable data on the actual state of hyperparathyroid patients in the Czech Republic. 112) Prague Medical IntroductionPrimary hyperparathyroidism (PHPT) is currently the most common endocrine disorder after diabetes and thyroid diseases particularly in postmenopausal women. The clinical presentation of PHPT has dramatically changed in the last 40 years. The disease is now characterized by mild hypercalcemia, mild glandular enlargement and less traditional classic bone and kidney manifestations (Adami et al., 2002). Up to about 40 years ago in former Czechoslovakia as well as in other Western countries the disease was rarely diagnosed. The change in clinical presentation was largely due to the introduction of automated serum calcium and iPTH (intact parathyroid hormone) measurement. PHPT mainly affects middle-aged adults, peaks in the seventh decade and occurs more frequently in females than in males. The incidence of PHPT has changed dramatically. In the early 1970 the estimated incidence of PHPT in former Czechoslovakia was approximately 8 cases per 100 000 persons per year. Our data showed that the incidence of PHPT increased sharply to 24 cases per 100 000 persons per year in same community with the introduction of automated serum calcium and iPTH measurement. Earlier PHPT was considered a rare illne...

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“…27 The surgical patients in our sample showed no improvement in cardiovascular risk factors at one year of follow-up. As regards HBP, some studies, 12,28 but not all, 29 have shown blood pressure decreases after surgery. It should be noted that in studies showing no changes, mean baseline blood pressure values were not excessively elevated, as occurred in our study.…”

Section: Discussionmentioning

confidence: 99%

“…3,12,13 It has also been shown that PHP induces left ventricular hypertrophy in the absence of HPB, and that PTH levels correlate to left ventricular mass. 14 After surgery, regression of left ventricular hypertrophy has been reported in a variable time period ranging from one to five years, 15 but subsequent studies do not support this effect in patients with mild PHP.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors in patients with asymptomatic primary hyperparathyroidism

García-Martín

Reyes-García

García-Castro

et al. 2014

Endocrinología y Nutrición (English Edition)

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Improvement of Hypertension after Parathyroidectomy of Patients Suffering from Primary Hyperparathyroidism

Cited by 48 publications

References 27 publications

Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism

Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism

Changes in the Pattern of Primary Hyperparathyroidism in Czech Republic

Cardiovascular risk factors in patients with asymptomatic primary hyperparathyroidism

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