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Higher parathyroid hormone levels may increase hypertension risk
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Higher serum levels of parathyroid hormone may be associated with the pathogenesis of hypertension, according to findings from the Multi-Ethnic Study of Atherosclerosis.
Notably, the study results did not indicate a significant association between 25-hydroxyvitamin D, or 25-(OH)D, deficiency and hypertension.
The prospective, community-based study evaluated 3,002 patients enrolled from six US centers between 2000 and 2002. The study participants were free of baseline CVD and hypertension, and were aged 45 to 84 years (mean, 59 ± 9.7 years).
Baseline blood samples were evaluated for total serum 25-(OH)D via liquid chromatography-mass spectroscopy and for parathyroid hormone concentrations using an automated, two-site immunoassay.
Incident hypertension was defined as systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg or use of any antihypertensive medication on follow-up visits.
After a median follow-up of 9 years, 41% of participants developed hypertension. The mean blood concentration of 25-(OH)D was 26.3 ± 11.2 ng/mL, and the mean parathyroid hormone concentration was 41.2 ± 17.3 pg/mL. Serum concentration of 25-(OH)D <20 ng/mL was linked to an increased risk for hypertension compared with 25-(OH)D levels ≥30 ng/mL (OR=1.28; 95% CI, 1.09-1.5), but this correlation was not statistically significant after adjustment for confounding factors (OR=1.13; 95% CI, 0.96-1.33). Parathyroid hormone level ≥65 pg/mL was related to a significantly greater risk for hypertension compared with concentrations <33 pg/mL. This association remained significant after adjusting for confounders (OR=1.27; 95% CI, 1.01-1.59).
Among the hypertension risk factors considered as possible confounders, BMI had the most significant effect on the final results, the researchers wrote. An interaction was observed between increasing BMI and both 25-(OH)D and parathyroid hormone, in relation to hypertension risk (P<.001). Adjustment for BMI as a continuous variable, however, eliminated the significance of both associations among overweight and obese patients.
“We report associations of higher [parathyroid hormone] concentrations with greater incident hypertension in a community-based, middle-aged multi-ethnic cohort,” the researchers wrote. “Vitamin D deficiency and [parathyroid hormone] excess are common findings among the general population and a better understanding of the clinical implications of the pathogenesis of hypertension may help to promote CV health.”
Disclosure: The researchers report no relevant financial disclosures.
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