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Cardiovascular findings in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism: A cohort study
Line Underbjerg1, Tanja Sikjaer1, Lars Rejnmark1
1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Insights
Patients with nonsurgical hypoparathyroidism (Ns-HypoPT) exhibit greater arterial stiffness and heart rate compared to those with pseudohypoparathyroidism (PHP). These findings suggest potential cardiovascular risks associated with Ns-HypoPT.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Cardiovascular health data for nonsurgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP) are limited.
- Understanding cardiovascular profiles in these conditions is crucial for patient management.
Purpose of the Study:
- To compare the cardiovascular health profiles of patients with Ns-HypoPT and PHP.
- To identify differences in arterial stiffness, pulse wave velocity (PWV), and blood pressure (BP) between the two groups.
Main Methods:
- A cohort of 56 Ns-HypoPT patients and 30 PHP patients were assessed.
- Clinical examinations included blood sampling, arterial stiffness, PWV, and BP measurements.
- Genetic screening was performed on over 70% of participants in both groups.
Main Results:
- PHP patients had lower high-density lipoprotein (HDL) cholesterol and average glucose (HbA1c).
- Ns-HypoPT patients showed significantly higher PWV, even after adjustments for cardiovascular risk factors.
- Heart rate was significantly elevated in Ns-HypoPT patients compared to PHP patients.
Conclusions:
- Ns-HypoPT is associated with increased arterial stiffness and heart rate compared to PHP.
- These findings may indicate a higher cardiovascular disease risk in Ns-HypoPT patients.
- The cardiovascular system in PHP may exhibit resistance to parathyroid hormone (PTH).
Objective:
As only sparse data are available on indices of cardiovascular health among patients with nonsurgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP), we aimed to compare the cardiovascular profile between these groups of patients.
Methods:
A total of 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 (BP). Arterial stiffness and PWV were measured using AtCor SphygmoCor-XCEL (Atcor Medical Pty Ltd, Sydney, NSW, 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 BP and 24-hour ambulatory BP 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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