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Παρασκευή 28 Δεκεμβρίου 2018

Cardiovascular findings in patients with non‐surgical hypoparathyroidism and pseudohypoparathyroidism: a cohort study

Abstract

Objective

As only sparse data are available on indices of cardiovascular health among patients with non‐surgical hypoparathyroidism (Ns‐HypoPT) and pseudohypoparathyroidism (PHP), we aimed to compare the cardiovascular profile between these groups of patients.

Methods

56 patients with Ns‐HypoPT and 30 with PHP were included and underwent a clinical examination including blood sampling and measurements of arterial stiffness, pulse wave velocity (PWV) and blood pressure. Arterial stiffness and pulse wave velocity was measured using AtCor SpygmoCor‐XCEL (Atcor Medical Pty Ltd, Sydney, Australia)

Results

Patients with Ns‐HypoPT had an average age of 47±17 years (68% females) and PHP patients 36±13 years (80% females). Over 70% in both groups were genetically screened. Groups did not differ in terms of a history of cardiovascular disease, smoking status, use of calcium and vitamin D supplements or treatment with cholesterol lowering‐ or antihypertensive drugs. Compared with Ns‐HypoPT, PHP patients had significantly lower levels of high density lipoproteins (HDL) cholesterol and average glucose from HbA1c (pboth=0.01). PWV was significantly higher among patients with Ns‐HypoPT (pcrude=0.02), even after adjustment for mean arterial pressure, body mass index, age and gender (padjusted<0.01). Heart rate was significantly higher in Ns‐HypoPT compared with PHP (p=0.03). Office blood pressure and 24‐hour ambulatory blood pressure did not differ between groups (p>0.05).

Conclusion

Patients with Ns‐HypoPT have compared with PHP a higher arterial stiffness and heart rate. This has been associated with an increased risk of cardiovascular disease. Our data suggest that resistance to PTH is present in the cardiovascular system in PHP.

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