Relationship between parathyroid hormone and left ventricular mass in moderate essential hypertension

Duprez, Daniel; Bauwens, Frank; Buyzere, Marc De; Backer, Tine De; Kaufman, Jean-Marc M.; Hoecke, Jose Van; Vermeulen, A.; Clément, Denis

doi:10.1097/00004872-199112006-00042

Cited by 7 publications

(6 citation statements)

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“…20 Further evidence for the role of secondary hyperparathyroidism in the pathogenesis of CKD‐related cardiovascular disease can be derived from clinical and experimental studies. Both primary and secondary hyperparathyroidism are associated with left ventricular hypertrophy, 21–22 and in the context of hemodialysis, parathyroidectomy improves left ventricular function. 23 …”

Section: Discussionmentioning

confidence: 99%

Effects of Cinacalcet on Atherosclerotic and Nonatherosclerotic Cardiovascular Events in Patients Receiving Hemodialysis: The EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial

Wheeler

London²,

Parfrey

et al. 2014

JAHA

114

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BackgroundPremature cardiovascular disease limits the duration and quality of life on long‐term hemodialysis. The objective of this study was to define the frequency of fatal and nonfatal cardiovascular events attributable to atherosclerotic and nonatherosclerotic mechanisms, risk factors for these events, and the effects of cinacalcet, using adjudicated data collected during the EValuation of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial.Methods and ResultsEVOLVE was a randomized, double‐blind, placebo‐controlled clinical trial that randomized 3883 hemodialysis patients with moderate to severe secondary hyperparathyroidism to cinacalcet or matched placebo for up to 64 months. For this post hoc analysis, the outcome measure was fatal and nonfatal cardiovascular events reflecting atherosclerotic and nonatherosclerotic cardiovascular diseases. During the trial, 1518 patients experienced an adjudicated cardiovascular event, including 958 attributable to nonatherosclerotic disease. Of 1421 deaths during the trial, 768 (54%) were due to cardiovascular disease. Sudden death was the most frequent fatal cardiovascular event, accounting for 24.5% of overall mortality. Combining fatal and nonfatal cardiovascular events, randomization to cinacalcet reduced the rates of sudden death and heart failure. Patients randomized to cinacalcet experienced fewer nonatherosclerotic cardiovascular events (adjusted relative hazard 0.84, 95% CI 0.74 to 0.96), while the effect of cinacalcet on atherosclerotic events did not reach statistical significance.ConclusionsAccepting the limitations of post hoc analysis, any benefits of cinacalcet on cardiovascular disease in the context of hemodialysis may result from attenuation of nonatherosclerotic processes.Clinical Trials RegistrationUnique identifier: NCT00345839. URL: ClinicalTrials.gov.

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Section: Discussionmentioning

confidence: 99%

Effects of Cinacalcet on Atherosclerotic and Nonatherosclerotic Cardiovascular Events in Patients Receiving Hemodialysis: The EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial

Wheeler

London²,

Parfrey

et al. 2014

JAHA

114

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“…[20][21][22][23][24] Secondary hyperparathyroidism is also associated with left ventricular hypertrophy. [25][26][27][28][29] In combination with the higher prevalence of hypertension, this could contribute to the greater prevalence of congestive heart failure in SHPT patients. Several studies have suggested that hyperlipemia in renal failure is related to elevated PTH levels.…”

Section: Discussionmentioning

confidence: 99%

Survival after Parathyroidectomy in Patients with End‐stage Renal Disease and Severe Hyperparathyroidism

et al. 2007

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“…Even though some results regarding the relationship between hypertrophy and the severity of hypertension are contradictory, a number of studies have reported that the prevalence of hypertrophy increases with the severity of hypertension (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…It induces LVH and dilatation, which can lead to heart failure (7,8). The reasons for the development of LVH in patients with essential hypertension have not been established, and whether or not LVH results from long-term blood pressure (BP) elevation or non-hemodynamic factors affecting the myocardium is still a matter of debate (4,9,10).…”

Section: Introductionmentioning

confidence: 99%

Correlation between Left Ventricular Mass Index and Calcium Metabolism in Patients with Essential Hypertension

2013

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IntroductionLeft ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular morbidity and mortality in hypertensive patients (1-3). Even though some results regarding the relationship between hypertrophy and the severity of hypertension are contradictory, a number of studies have reported that the prevalence of hypertrophy increases with the severity of hypertension (4, 5).Essential hypertension is a multifactorial condition affecting a large percentage of the adult Turkish population (33.7%) (6). It induces LVH and dilatation, which can lead to heart failure (7, 8). The reasons for the development of LVH in patients with essential hypertension have not been established, and whether or not LVH results from long-term blood pressure (BP) elevation or non-hemodynamic factors affecting the myocardium is still a matter of debate (4, 9, 10).Disturbances in calcium metabolism due to an increase in urinary calcium excretion have been observed in patients with essential hypertension. Thus, it has been suggested that there might be a relationship between calcium metabolism and myocardial hypertrophy (9). Parathormone (PTH) and vitamin D are the major calcitropic hormones, and the levels of these two hormones have been reported to vary in patients with essential hypertension (11). In several studies, a relationship between hyperparathyroidism with LVH and BP elevation has been demonstrated in hypertensive patients (1,(12)(13)(14). However, whether the increase in PTH level is the result of or the reason for the BP elevation has not been elucidated (15). In addition, it has been reported that PTH increases cytosolic free calcium, and this might cause myocardial hypertrophy through biochemical mechanisms (16). Vitamin D increases the calcium level in myocytes as well, and subsequently cardiac contractility increases and affects the PTH level through receptor binding mechanisms (11).The purpose of the present study was to determine the relationship between calcium metabolism and hypertension by comparing healthy individuals and patients newly diagnosed with mild and moderate essential hypertension, and to elucidate the role of non-hemodynamic factors in the development of LVH in the hypertensive group. Study Design: Cross sectional case-control study. Material and Methods Study populationMaterial and Methods: Twenty-seven patients with essential hypertension and 20 healthy individuals were compared with respect to calciotropic hormones, left ventricular mass index (LVMI), and urinary and serum biochemical parameters. The correlations between parathormone, vitamin D, and calcitonin levels and LVMI and blood pressure elevation were determined.Results: The parathormone level was significantly higher (p=0.006) and vitamin D level was significantly lower (p=0.01) in the patient group compared with the control group. However, the two groups were similar in terms of albumin-corrected calcium levels, which were within the normal range (p=0.988). The serum sodium (p=0.014) and urinary calcium (p=0.003) levels and L...

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Relationship between parathyroid hormone and left ventricular mass in moderate essential hypertension

Cited by 7 publications

References 0 publications

Effects of Cinacalcet on Atherosclerotic and Nonatherosclerotic Cardiovascular Events in Patients Receiving Hemodialysis: The EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial

Effects of Cinacalcet on Atherosclerotic and Nonatherosclerotic Cardiovascular Events in Patients Receiving Hemodialysis: The EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial

Survival after Parathyroidectomy in Patients with End‐stage Renal Disease and Severe Hyperparathyroidism

Correlation between Left Ventricular Mass Index and Calcium Metabolism in Patients with Essential Hypertension

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