Adrenal responses to subtotal parathyroidectomy for primary hyperparathyroidism
Abstract
Although it is well known that hypertension is often associated with primary hyperparathyroidism and that parathyroidectomy reverses or reduces this abnormality, the etiology of elevated blood pressure in hyperparathyroidism is still conjectural. We have analyzed serum calcium, blood pressure, and metabolites of adrenal cortical hormones before and after surgical therapy for hyperparathyroidism in 10 normotensive and six hypertensive patients with primary hyperparathyroidism. Successful parathyroidectomy lowered serum calcium (P less than 0.01) and diastolic blood pressure (P less than 0.05) in all subjects. Mean urinary aldosterone and Porter-Silber chromagens were within normal limits preoperatively in normotensive as well as hypertensive subjects. After parathyroidectomy, aldosterone levels as well as Porter-Silber chromagens decreased significantly in all patients (P less than 0.01). However, when normotensive and hypertensive subjects were analyzed separately, the decrease in aldosterone levels was significant only in the normotensive group (P less than 0.05) whereas the decrease in Porter-Silber chromagens reached significancy only in the hypertensive group (P less than 0.01). The results indicate that surgical therapy for hyperparathyroidism lowers serum calcium and blood pressure and is associated with a decrease in the excretion of adrenal steroid metabolites. It is suggested that the temporal relationship which exists between ionized calcium and steroidogenesis in hyperparathyroid patients contributes at least in part to the generalized decrease in blood pressure observed after successful parathyroidectomy.
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- Authors
- Pacifici, R., Perry, H. M., Shieber, W., Biglieri, E., Droke, D. M., & Avioli, L. V.
- Affiliations
- Washington University in St. Louis (US)
- Saint Louis University (US)
- University of California, San Francisco (US)
- ORCID
- Pacifici, Roberto
- Venue
- Calcified Tissue International
- Published
- 1987-09
- Volume
- 41
- Issue
- 3
- Pages
- 119-123
- ISSN
- 0171-967X (ISSN-L)
- 1432-0827
- OpenAlex
- W2029914971
- Cited by
- 19
- References
- 39
- Citations by year
- 2021: 2 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2013: 2 · 2012: 4
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Calcified Tissue International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01am006415-24, 2t32am007033-12)
- National Center for Research Resources (RR.00036)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- primary hyperparathyroidism, subtotal parathyroidectomy, hypertension, serum calcium, aldosterone, steroidogenesis, ionized calcium, blood pressure reduction
- MeSH terms
- Adrenal Cortex, Adult, Aged, Aldosterone, Blood Pressure, Calcium, Female, Humans, Hyperparathyroidism, Male, Middle Aged, Pigments, Biological, 17-Hydroxycorticosteroids
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