Calcium, calcium regulatory hormones, and calcimimetics: impact on cardiovascular mortality

Calcemia is a risk factor for cardiovascular (CV) events in dialyzed patients. The relation between serum calcium and cardiovascular events is continuous and linear. Calcium plays a potent role in the genesis of cardiovascular dysfunction, particularly by promoting vascular calcification. Parathyroid hormone (PTH) also is associated with increased CV risk in both primary and secondary hyperparathyroidism. There is a nonlinear relationship between PTH and CV risk; both high and low PTH concentrations increase CV risk. The CV risk profile (BP, dyslipidemia) is strikingly ameliorated by the administration of calcimimetics. Apart from lowering PTH, whether calcimimetics have intrinsic effects on CV risk profile is unknown.