What’s the connection between hypertension (HTN) and primary hyperparathyroidism (PHPT)?

The prevalence of HTN in patients with PHPT has generally been shown to be higher than the general population irrespective of age. Because elevated PTH levels have also been reported in some patients with essential HTN, the association of high PTH levels with HTN may not always be causal in nature1.

Parathyroid HTN is characterized by increased total peripheral vascular resistance, possibly related to dysregulation of major endocrine pressor factors (eg, sympathetic nervous system and/or the renin-angiotensin-aldosterone  axis), dysfunction of resistance vessels due to altered vasodilatory response and/or enhanced vascular constriction due to to pressor hormones. Abnormal calcium metabolism at the level of vascular smooth muscle cells may be the final common pathway1.

In a longitudinal prospective cohort study of mostly older white women, history of HTN and use of furosemide were associated with a signficantly higher risk of PHPT2.

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1. Schiff H, Lang SM. Hypertenson secondary to PHPT: cause or coincidence. Int J Endocrinol 2011;2011, Article ID 974647,6 pages,  http://dx.doi.org/10.1155/2011/974647.
2. Vaidya A, Curhan GC, Paik JM, Kronenberg H, Taylor EN. Hypertension antihypertensive medications, and risk of incident primary hyperparathyroidism. J Clin Endocrinol Metabl 2015;100:2396-2404.  https://www.ncbi.nlm.nih.gov/pubmed/25885946

What’s the connection between hypertension (HTN) and primary hyperparathyroidism (PHPT)?

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