@article{3020974, title = "Cardiovascular risk in patients with primary hyperparathyroidism", author = "Tournis, S. and Makris, K. and Cavalier, E. and Trovas, G.", journal = "Current Pharmaceutical Design", year = "2020", volume = "26", number = "43", pages = "5628-5636", publisher = "Bentham Science Publishers", issn = "1381-6128", doi = "10.2174/1381612824999201105165642", keywords = "antihypertensive agent; bisphosphonic acid derivative; calcium; cinacalcet; denosumab; high density lipoprotein cholesterol; lipid; parathyroid hormone; parathyroid hormone receptor; parathyroid hormone related protein; raloxifene; thiazide diuretic agent; triacylglycerol; calcium; parathyroid hormone, Article; cardiovascular risk; chronic kidney failure; chronotropism; clinical feature; diabetes mellitus; disease severity; dyslipidemia; endothelial dysfunction; fracture; heart arrhythmia; heart left ventricle hypertrophy; human; hypercalcemia; hypertension; inotropism; morbidity; mortality; nephrolithiasis; parathyroidectomy; patient monitoring; postmenopause osteoporosis; prevalence; primary hyperparathyroidism; priority journal; risk assessment; survival rate; treatment indication; vasodilatation; cardiovascular disease; complication; primary hyperparathyroidism; risk factor, Calcium; Cardiovascular Diseases; Heart Disease Risk Factors; Humans; Hyperparathyroidism, Primary; Parathyroid Hormone; Parathyroidectomy; Risk Factors", abstract = "Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders characterized by parathyroid hormone (PTH)-dependent hypercalcemia. Cardinal features include low trauma fractures, nephrolithiasis, and chronic kidney disease. Several experimental studies established that parathyroid hormone exerts actions on the cardiovascular (CV) system, including vasodilatation and positive inotropic and chronotropic effects. Observational studies, especially in severe cases, report a higher prevalence of hypertension, diabetes mellitus, lipid abnormalities, endothelial dysfunction, arrhythmias, and left ventricular hypertrophy in patients with PHPT, while the risk of CV events seems to be increased in severe cases. However, the effect of surgery is inconsistent on CV abnormalities and, more importantly, on CV disease (CVD) events, especially in mild cases. In the current review, we describe the available evidence linking PHPT and CVD, as well as the effect of surgical management and pharmacological treatment on CVD manifestations in patients with PHPT. Based on the current evidence, CVD is not considered an indication for surgery. © 2020 Bentham Science Publishers." }