Patients with primary aldosteronism appeared to have elevated
parathyroid hormone levels compared with those with essential hypertension,
according to recent data.
Previous studies have linked aldosterone excess to increased risk for
cardiovascular morbidity and mortality, as well as hypercalciuria, which may
contribute to the development of hyperparathyroidism, researchers in Austria
wrote. Data in humans, however, are limited. Therefore, the researchers
examined participants with hypertension from the Graz Endocrine Causes of
Hypertension (GECOH) study to assess the relationship between primary
aldosteronism and parathyroid hormone (PTH) levels, calcium homeostasis and
vitamin D status.
Of 192 patients included in the analysis, 10 had primary aldosteronism
and 182 had essential hypertension, according to the researchers. Results
revealed significantly increased PTH levels among patients with primary
aldosteronism vs. those with essential hypertension (67.8 pg/mL vs. 46.5 pg/mL;
P=.002). PTH concentrations, however, decreased to 43.9 pg/mL in
patients with primary aldosteronism after specific treatment with adrenal
surgery or mineralocorticoid receptor antagonists (P=.023).
Additionally, the researchers noted significantly lower serum calcium
and albumin-corrected calcium in patients with primary aldosteronism vs. those
with essential hypertension (2.26 mmol/L vs. 2.35 mmol/L; P=.013). Data
also highlighted a nonsignificant trend toward increased spot urine calcium to
creatinine ratio in patients with primary aldosteronism. No differences in
serum 25-hydroxyvitamin D levels, however, were observed between groups.
"Our results show that primary aldosteronism patients are prone to
secondary hyperparathyroidism that can be successfully treated with
mineralocorticoid receptor antagonists or adrenal surgery," the researchers
wrote. "Further studies are warranted to evaluate whether PTH has implications
for diagnostic procedures for primary aldosteronism and whether
mineralocorticoid receptor antagonists have, beyond primary aldosteronism, a
general impact on PTH and calcium metabolism."
Disclosure: The researchers report no relevant financial