ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM AND CARDIOVASCULAR PATHOLOGY

Abstract

Parathyroid hormone (PTH) controls regulation of phosphorus-calcium metabolism and affects the cardiovascular system. PTH receptors have been found in the myocardium, smooth muscle cells of the vessels and the glomerular zone of the adrenal cortex. Cardiovascular diseases are the most common cause of high mortality among patients with primary hyperparathyroidism (PHPT). Moreover, asymptomatic patients also demonstrate cardiovascular involvement due to the direct effects of PTH. The most common are arterial hypertension, left ventricular myocardial hypertrophy and diastolic dysfunction, as well as intima-media complex pathology, vascular stiffness and endothelial dysfunction, calcifications and conduction disorders. Nevertheless, the causeeffect relationship and the impact on cardiovascular and overall mortality in asymptomatic PHPT are unknown. The reversibility of the abnormal changes and reduction in mortality after surgical treatment in asymptomatic PHPT are not well investigated. Regarding the high prevalence of asymptomatic PHPT (often without absolute indications for surgical treatment), cardiovascular complications, their impact on cardiovascular and general mortality, and reversibility after surgical treatment are highly important.