ARTERIAL STIFFNESS IN NORMOTENSIVE PATIENTS WITH HYPOPARATHYROIDISM COMPARED TO CONTROLS

Abstract

Objective: Hypoparathyroidism is a rare disease characterized by the inability of parathyroid hormone (PTH) to maintain calcium homeostasis. Multiple etiologies, congenital or acquired can cause this morbidity. However, the most common cause is hormone deficiency secondary to cervical surgical explorations. Patients with post-surgical hypoparathyroidism have an increased risk of mortality, with various clinical and molecular evidence of the effects on the cardiovascular system. This study aimed to assess arterial stiffness by measuring the carotid-femoral pulse wave velocity (PWV) in a population of patients with hypoparathyroidism. Design and method: This is a cross-sectional study with 30 patients with post-surgical hypoparathyroidism and 25 normal volunteers from the Endocrinology Outpatient Clinic of the Medical School. Arterial stiffness was evaluated by the analysis of PWV using SphygmoCor system. Statistical analysis was made with software IBM-SPSS Statistics 27 (IBM Corporation, NY, USA). Results: The average PWV in patients with hypoparathyroidism was not different compared to controls (8.70 vs 7.50; p = 0.084). However, when comparing only normotensive patients in both groups (21 hypoparathyroidism and 16 controls), levels of PWV in patients with hypoparathyroidism was higher and statistically significant (7.64 vs 6.50; p = 0.039). Age, hypertension, LDL cholesterol levels, ionized calcium, total calcium, and the Calcium x Phosphorus product were independent predictor variables for PWV. Conclusions: Post-surgical hypoparathyroidism increases arterial stiffness in normotensive individuals, evaluated by PWV and total calcium level, as well the Calcium x Phosphorus product are involved in this condition. Therefore, vascular stiffness may be one of the pathophysiologic mechanisms of the cardiovascular disease in patients with hypoparathyroidism. Further studies are necessary to elucidate this condition.