Primary hyperparathyroidism linked to cardiometabolic risks

Individuals with primary hyperparathyroidism (pHPT) face long-term cardiometabolic risks, as reported in a retrospective study.

Researchers used data from Clalit Health Services in Israel. They looked at 200,464 individuals (median age 66 years, 68.3 percent female), including 50,199 patients with pHPT and 150,265 controls matched according to age, sex, and socioeconomic status. In the pHPT group, 6,654 underwent parathyroidectomy. Patients with secondary hyperparathyroidism were excluded. Follow-up duration was up to 15 years.

The outcomes of interest were hypertension, type 2 diabetes (T2D), cardiovascular disease (CVD), and cerebrovascular accidents (CVA). These events were analysed using Kaplan-Meier curves and Cox proportional hazards regression models.

Compared with controls, patients with pHPT were at increased long-term risk of hypertension (adjusted hazard ratio [AHR], 1.22, 95 percent confidence interval [CI], 1.17–1.33; p<0.001), T2D (AHR, 1.07, 95 percent CI, 1.01–1.16; p=0.02), CVD (AHR, 1.28, 95 percent CI, 1.21–1.42; p<0.001), and CVA (AHR, 1.22, 95 percent CI, 1.17–1.33; p<0.001).

In the pHPT group, parathyroidectomy had a protective effect on the risk of T2D only compared with nonsurgical management, with the incidence dropping from 15.18 (95 percent CI, 14.58–15.81) to 10.77 (95 percent CI, 9.80–11.83) per 1,000 person-years (AHR, 0.56, 95 percent CI, 0.30–0.89; p=0.002).

The findings support the consideration of surgical intervention in appropriate pHPT patients.