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Cited by 7Parathyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryBlood Pressure and Hypertension Studies

Persistence of "non-dipping" pattern in blood pressure after curative parathyroidectomy in apparently normotensive patients with symptomatic primary hyperparathyroidism

Pal, Rimesh, Mukherjee, Soham, Bhadada, Sanjay K., Bhansali, Anil, Puravoor, Jayaprakash, Behera, Arunanshu·2020·Minerva Endocrinologica
DOI 10.23736/s0391-1977.19.03104-3
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Abstract

BACKGROUND: The prevalence of hypertension in primary hyperparathyroidism (PHPT) varies from 20-80% with data being based on office-based blood pressure measurements. Little is known about ambulatory monitoring of blood pressure (AMBP) in PHPT and changes in blood pressure (BP) variables post-curative parathyroidectomy. Hence, we conducted a prospective study wherein we performed AMBP in apparently normotensive patients with PHPT and reevaluated them 3 months post-curative parathyroidectomy. METHODS: Consecutive patients with symptomatic PHPT aged 20 years and above underwent 24 hours AMBP at enrollment and at 3 months after successful parathyroidectomy. Pre- and postoperative BP variables were compared and correlated with serum calcium, creatinine and intact parathyroid hormone (iPTH) levels. RESULTS: After exclusion, 17 symptomatic PHPT patients were enrolled in the study. AMBP detected hypertension in 4 (23.5%) patients. There was a significant reduction in the average nighttime systolic (P=0.007) and diastolic BP (P=0.034) after parathyroidectomy. However, the average 24 hours systolic/diastolic BP, daytime systolic/diastolic BP and average 24 hours mean arterial pressure did not differ before and after surgery. Non-dipping blood pressure pattern was seen in 53% of patients at presentation and persisted in 50% of cases after successful surgery. None of the biochemical parameters significantly correlated with any BP variable. CONCLUSIONS: AMBP can help detect hypertension in patients with PHPT that remains unrecognized with routine office-based blood pressure measurement. In addition, AMBP detects loss of normal dipping pattern in BP that persists in almost half of the patients even after successful parathyroidectomy, perhaps because of permanent vascular damage induced by PHPT.

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Crossref · 10.23736/s0391-1977.19.03104-3

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Authors
Pal, R., Mukherjee, S., Bhadada, S. K., Bhansali, A., Puravoor, J., & Behera, A.
Affiliations
Post Graduate Institute of Medical Education and Research (IN)
Corresponding author
Bhadada, Sanjay K.
ORCID
Venue
Minerva Endocrinologica
Publisher
Edizioni Minerva Medica
Published
2020-09
Volume
45
Issue
3
Pages
181-188
ISSN
  • 0391-1977 (ISSN-L)
  • 1827-1634
DOI
10.23736/s0391-1977.19.03104-3
OpenAlex
W2992318969
Cited by
7
References
46
Citations by year
2025: 1 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1
FWCI
0.94
Type
journal article
Language
en
Open access
closed
Locations
  • Minerva Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
primary hyperparathyroidism, parathyroidectomy, non-dipping blood pressure, ambulatory blood pressure monitoring, hypertension, nocturnal blood pressure dipping, postoperative blood pressure, serum calcium, intact parathyroid hormone, vascular injury
MeSH terms
Adult, Blood Pressure, Female, Humans, Male, Middle Aged, Prospective Studies, Parathyroidectomy, Treatment Outcome, Blood Pressure Monitoring, Ambulatory, Hyperparathyroidism, Primary, Young Adult, Arterial Pressure

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