Evaluation of Endothelial Responses in Individuals With Primary Hyperparathyroidism

Primary hyperparathyroidism is a prevalent endocrine disorder marked by excessive parathyroid hormone secretion. Beyond its classical biochemical features, accumulating evidence suggests that primary hyperparathyroidism may adversely affect cardiovascular homeostasis. In this context, we aimed to evaluate whether patients with primary hyperparathyroidism exhibit impaired vascular function and heightened systemic inflammation compared with matched healthy controls. This cross-sectional study initially recruited 39 patients with primary hyperparathyroidism. After predefined exclusion criteria were applied, 30 patients with primary hyperparathyroidism were included and compared with 45 age-, sex-, and body mass index-matched healthy controls. Endothelium dependent and independent vasodilation were assessed using venous occlusion plethysmography. High-sensitivity C-reactive protein levels were measured. Endothelium-independent vasodilation was reduced in primary hyperparathyroidism compared to controls (-15.5%; p=0.01), indicating vascular smooth muscle dysfunction. High-sensitivity C-reactive protein levels were significantly higher in primary hyperparathyroidism (905.7%; p<0.001). The mean arterial pressure was elevated (~12.2%; p<0.001), with a higher prevalence of hypertension (60% vs. 35.6%; p=0.03). These findings suggest that primary hyperparathyroidism is associated with impaired vascular function and systemic inflammation, even in patients without overt cardiovascular disease. This highlights a possible subclinical cardiovascular risk in primary hyperparathyroidism and supports the need for further longitudinal studies to confirm these associations and their clinical relevance.