MON-525 Cardiovascular Status in Chronic Hypoparathyroidism: A Prospective Single-Center Analysis in 143 Patients

Abstract

Introduction: Chronic hypoparathyroidism (HPT) is characterized by low concentrations of parathyroid hormone (PTH) resulting in low calcium and high phosphate levels. Even though it is well known that long-term complications such as renal insufficiency, nephrocalcinosis and brain calcifications can occur in HPT, the risk of cardiovascular diseases still remains unclear. Objective: To perform a systematic assessment of cardiovascular function and long-term complications in a well characterized cohort of patients with HPT. Methods: 143 patients with chronic HPT (disease duration >6 months) were included and systematically examined regarding comorbidities as well as cardiovascular events. Participants were assessed by electrocardiogram, renal ultrasound, 24-hour blood pressure measurement and laboratory analysis. Results: Out of 143 patients (56±13yr, 76% female) 90% had postoperative HPT. 94% received treatment with calcium and/or activated vitamin D. Albumin-corrected serum calcium was below <2.0 mmol/l in 31% of patients. Prevalence of any of the following cardiovascular diseases: coronary heart disease, angina pectoris, myocardial infarction, heart failure, atrial fibrillation was 11%. 52% of patients with HPT had a history of hypertension. Mean blood pressure during 24-hour measurement (n=108) was at 130±17/80±12 mmHg. No significant differences in prevalence of hypertension (57% vs. 41%), 24 hour blood pressure (130±15/80±8 vs. 130±13/81±8 mmHg), or levels of NT-proBNP (n=101; 73, IQR 113 vs. 76, IQR 92 pg/ml) between normo- and hypocalcemic patients could be detected. QT-interval (n=131) was significantly prolonged in hypocalcemic patients (441±35 vs. 415±29 ms, p<0.001). Regarding further comorbidities 12% reported a history of kidney stones, 3.6% had nephrocalcinosis in renal ultrasound, 21% had a glomerular filtration rate lower than 60 ml/min/1,73m2 and 13% suffered from cataract. Conclusion: Here we report a high prevalence of hypertension in patients with HPT independend of their calcium levels. However, further comparison to the general German population, as well as prospective evaluation of cardiovascular events is needed to further establish the relevance of cardiovascular comorbidities in HPT.