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Disturbed calcium metabolism in subjects with elevated diastolic blood pressure
H Reichel1, R Liebethal, H W Hense
1Medizinische Klinik, Universität Heidelberg.
Insights
Essential hypertension may involve altered calcium metabolism. This study found higher parathyroid hormone (PTH) in men with high blood pressure, despite normal vitamin D levels, suggesting increased parathyroid activity.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Calcium Metabolism
Background:
- Essential hypertension is linked to calcium metabolism disturbances, but findings are inconsistent.
- Understanding calcium's role in hypertension is crucial for developing effective treatments.
Purpose of the Study:
- To investigate calcium metabolism parameters in untreated men with essential hypertension.
- To compare parathyroid hormone (PTH) and vitamin D levels between hypertensive and normotensive individuals.
Main Methods:
- Cross-sectional study of randomly selected male subjects.
- Measurement of diastolic blood pressure, serum calcium, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and carboxy-terminal PTH.
- Comparison of parameters between groups with high (≥101 mmHg) and low (<62 mmHg) diastolic blood pressure.
Main Results:
- Hypertensive men (n=78) had significantly higher PTH levels (median 114 vs. 43 pmol/l) compared to normotensive controls (n=79).
- Individuals with hypertension exhibited lower total serum calcium (2.41 vs. 2.47 mmol/l).
- No significant differences in 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D were observed between groups. PTH correlated negatively with diastolic pressure (r=-0.39).
Conclusions:
- Elevated parathyroid hormone (PTH) activity may contribute to human hypertension.
- Increased parathyroid activity occurs independently of vitamin D metabolite levels in hypertension.
- Disturbed calcium metabolism, particularly PTH dysregulation, warrants further investigation in essential hypertension.
Abstract:
Essential hypertension has been associated with disturbed calcium metabolism, but the available data are controversial. We measured parameters of calcium metabolism in groups of untreated male subjects (n = 78) with elevated diastolic blood pressure (101 +/- 6 mmHg, mean +/- SD) and age-matched male subjects (n = 79) with low diastolic blood pressure (62 +/- 4 mmHg). The participants of the study were drawn from a random population sample. Subjects with high diastolic blood pressure had significantly higher carboxy-terminal parathyroid hormone (PTH) plasma concentrations than controls with low diastolic blood pressure (median 114 vs. 43 pmol/l, P less than 0.01). The 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations were comparable in both groups. Individuals with high diastolic blood pressure had significantly lower total serum calcium (2.41 +/- 0.10 vs. 2.47 +/- 0.10 mmol/l, mean +/- SD; P less than 0.01). PTH concentrations were correlated with diastolic pressure (r = -0.39, P less than 0.001). The data are compatible with increased parathyroid activity despite unchanged concentrations of vitamin D metabolites in human hypertension.