TY - JOUR
T1 - Enhanced parathyroid function in essential hypertension
T2 - A homeostatic response to a urinary calcium leak
AU - McCarron, David A.
AU - Pingree, Patricia A.
AU - Rubin, Robert J.
AU - Gaucher, Susan M.
AU - Molitch, Mark
AU - Krutzik, Siegfried
PY - 1980
Y1 - 1980
N2 - Disorders of calcium metabolism are not generally considered important either clinically or pathophysiologically in essential hypertension. Recent reports, though, suggest that increased parathyroid gland function may be one of the more common endocrine disturbances associated with hypertension. We measured serum parathyroid hormone (PTH) concentrations as well as routine blood and urine chemistries in 34 hypertensives. Their mean PTH, 79.1 ± 3.1 μllter Eq/μllter, was rignlflcaatiy higher (p < 0.025) than the mean PTH, 66.9 ± 33, of an age- and sex-matched nonnotenshe control population. The mean serum calcium, 9.5 ± 0.1 mg%, was identical in the two populations. Compared to a second age- aad sex-matched normotensive population, the hypertensives demonstrated a significant (p < 0.005) relative hypercalciuria. For any level of urinary sodium, hypertensives excreted more calcium. These preliminary data suggest that parathyroid gland function may be enhanced in essential hypertension. This increased gland activity appears, in part, to be an appropriate, physiologic response to a previously unrecognized relative hypercalciuria, or renal calclum leak, associated with essential hypertension. We conclude that the increased prevalence of hypertension in subjects with hyperparathyroidism probably represents the final event In a continuum that begins with obligatory urinary calclum losses in hypertensives, but whose pathological presentation is hyperparathyroidism. The results of this pilot study indicate a need for derivative experiments directed at defining the importance of our preliminary findings In the pathogenesis of human and experimental hypertension.
AB - Disorders of calcium metabolism are not generally considered important either clinically or pathophysiologically in essential hypertension. Recent reports, though, suggest that increased parathyroid gland function may be one of the more common endocrine disturbances associated with hypertension. We measured serum parathyroid hormone (PTH) concentrations as well as routine blood and urine chemistries in 34 hypertensives. Their mean PTH, 79.1 ± 3.1 μllter Eq/μllter, was rignlflcaatiy higher (p < 0.025) than the mean PTH, 66.9 ± 33, of an age- and sex-matched nonnotenshe control population. The mean serum calcium, 9.5 ± 0.1 mg%, was identical in the two populations. Compared to a second age- aad sex-matched normotensive population, the hypertensives demonstrated a significant (p < 0.005) relative hypercalciuria. For any level of urinary sodium, hypertensives excreted more calcium. These preliminary data suggest that parathyroid gland function may be enhanced in essential hypertension. This increased gland activity appears, in part, to be an appropriate, physiologic response to a previously unrecognized relative hypercalciuria, or renal calclum leak, associated with essential hypertension. We conclude that the increased prevalence of hypertension in subjects with hyperparathyroidism probably represents the final event In a continuum that begins with obligatory urinary calclum losses in hypertensives, but whose pathological presentation is hyperparathyroidism. The results of this pilot study indicate a need for derivative experiments directed at defining the importance of our preliminary findings In the pathogenesis of human and experimental hypertension.
KW - Parathyroid hormone
KW - Serum calclum
KW - Urinary calcium and sodium excretion
KW - Urinary calclum
KW - Urinary cyclic AMP/creatinine
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U2 - 10.1161/01.HYP.2.2.162
DO - 10.1161/01.HYP.2.2.162
M3 - Article
C2 - 7380520
AN - SCOPUS:0019310384
SN - 0194-911X
VL - 2
SP - 162
EP - 168
JO - Hypertension
JF - Hypertension
IS - 2
ER -