Related Experiment Video
Updated: Nov 16, 2025
Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Impact of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism: A narrative review
Samuel Frey1, Éric Mirallié1, Bertrand Cariou2
1Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France; Université de Nantes, Quai de Tourville, 44000, Nantes, France.
Insights
Parathyroidectomy (PTX) may improve cardiovascular risk in primary hyperparathyroidism (PHPT) patients with classical disease. However, evidence for mild PHPT is conflicting, requiring further research.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Surgical Research
Background:
- Primary hyperparathyroidism (PHPT) is a common endocrine disorder linked to bone, kidney, and cardiovascular issues.
- Cardiovascular risk is not a primary surgical indication for PHPT due to inconclusive evidence, especially for mild cases.
Purpose of the Study:
- To review the effects of parathyroidectomy (PTX) on cardiovascular risk in patients with PHPT.
- To synthesize current evidence on PTX's impact on cardiovascular outcomes in PHPT.
Main Methods:
- Literature review of articles published after 1990.
- Search conducted on the MEDLINE database via PubMed, focusing on English-language publications.
Main Results:
- Recent studies suggest PTX positively impacts cardiovascular morbidity and mortality in classical PHPT.
- Surgery improves hypertension, glucose homeostasis, vascular/cardiac remodeling, and ECG abnormalities in classical PHPT.
- Conflicting results exist for mild PHPT, with limited data and lack of randomized trials.
Conclusions:
- PTX appears beneficial for cardiovascular risk in classical PHPT, correlating with preoperative calcium/PTH levels.
- Further research is needed on PTX's effects on nocturnal hypertension and cardiac morphology/function.
- Surgery is not currently recommended for mild PHPT based on cardiovascular risk; more studies are essential.
Aims:
Primary hyperparathyroidism (PHPT), one of the most frequent endocrine disorders, is not only associated with bone and kidney disorders but also with increased cardiovascular risk. This cardiovascular risk is not part of the indication for surgery owing to discordant evidence of the effects of parathyroidectomy (PTX), especially in mild PHPT which is the most common presentation of PHPT. This literature review focuses on the effects of PTX on the cardiovascular risk in PHPT. The MEDLINE database was searched via the PubMed interface, selecting relevant articles published after 1990 in English.
Data Synthesis:
In the most recent series, PTX appeared to have a positive impact on cardiovascular morbidity and mortality. Surgery improves arterial hypertension, markers of glucose homeostasis, vascular and cardiac remodeling and electrocardiographic impairments due to classical PHPT. However, the results of surgery on mild PHPT are conflicting.
Conclusions:
PTX seems to improve cardiovascular risk in patients presenting the classical form of PHPT. This improvement is correlated with preoperative serum calcium and/or PTH level, depending on the cardiovascular risk factor. However, many aspects of this improvement are not fully understood. Future studies should assess the effects of PTX on nocturnal hypertension, cardiac morphology and functions. The results for mild PHPT are conflicting owing to the limited size of the cohorts included in studies and the lack of randomized trials. Surgery is not currently recommended for patients presenting mild PHPT based on the cardiovascular risk and more studies are needed to better understand the interest of PTX on cardiovascular outcomes.
Related Concept Videos
00:59The Parathyroid Glands
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...