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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Verheyen, N; Fahrleitner-Pammer, A; Pieske, B; Meinitzer, A; Belyavskiy, E; Wetzel, J; Gaksch, M; Grübler, MR; Catena, C; Sechi, LA; Van, Ballegooijen, AJ; Brandenburg, VM; Scharnagl, H; Perl, S; Brussee, H; März, W; Pilz, S; Tomaschitz, A.
Parathyroid hormone, aldosterone-to-renin ratio and fibroblast growth factor-23 as determinants of nocturnal blood pressure in primary hyperparathyroidism: the eplerenone in primary hyperparathyroidism trial.
J Hypertens. 2016; 34(9):1778-86 Doi: 10.1097/HJH.0000000000001004 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Verheyen Nicolas Dominik
Co-Autor*innen der Med Uni Graz
Belyavskiy Evgeny
Brussee Helmut
Fahrleitner-Pammer Astrid
Grübler Martin
Keppel Martin
März Winfried
Meinitzer Andreas
Perl Sabine
Pieske Burkert Mathias
Pilz Stefan
Scharnagl Hubert
Tomaschitz Andreas
Wetzel Julia

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OBJECTIVES: The high prevalence of arterial hypertension in primary hyperparathyroidism (pHPT) is largely unexplained. Apart from parathyroid hormone (PTH), the mineral hormones fibroblast growth factor (FGF)-23 and aldosterone-to-renin ratio (ARR) are upregulated in pHPT. We aimed to determine whether nocturnal blood pressure (BP) is related with PTH, FGF-23 or ARR in a relatively large sample of pHPT patients. METHODS: Cross-sectional data of the single-center "Eplerenone in Primary Hyperparathyroidism" trial were used. All patients with a biochemical diagnosis of pHPT who had both available 24-h ambulatory BP monitoring and valid laboratory data were included. RESULTS: Full data were available in 136 patients (mean age 67 ± 10 years, 78% women). Median PTH was 99 (interquartile range: 82-124) pg/ml and mean calcium was 2.63 ± 0.15 mmol/l. ARR, but not PTH or FGF-23, was significantly and directly related with nocturnal SBP (Pearson's r = 0.241, P < 0.01) and DBP (r = 0.328, P < 0.01). In multivariate regression analyses, with adjustment for age, sex, PTH, FGF-23, traditional cardiovascular risk factors, antihypertensive medication and parameters of calcium metabolism ARR remained significantly and directly related with nocturnal BP (SBP: adjusted β-coefficient = 0.289, P < 0.01; DBP: β = 0.399, P < 0.01). The relationship between ARR and nocturnal SBP was exclusively present in patients with PTH levels above the median of 99 pg/ml. CONCLUSION: ARR, but not FGF-23 or PTH, was independently and directly related with nocturnal BP parameters in patients with pHPT, and this relationship was dependent on pHPT disease severity. Inappropriately, elevated aldosterone may partially explain the high prevalence of arterial hypertension in pHPT.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Aldosterone - blood
Antihypertensive Agents - therapeutic use
Blood Pressure - administration & dosage
Blood Pressure Monitoring, Ambulatory - administration & dosage
Calcium - blood
Circadian Rhythm - administration & dosage
Cross-Sectional Studies - administration & dosage
Diastole - administration & dosage
Eplerenone - administration & dosage
Female - administration & dosage
Fibroblast Growth Factor-23 - administration & dosage
Fibroblast Growth Factors - blood
Humans - administration & dosage
Hyperparathyroidism, Primary - blood, complications, physiopathology
Hypertension - blood, etiology
Male - administration & dosage
Middle Aged - administration & dosage
Mineralocorticoid Receptor Antagonists - therapeutic use
Parathyroid Hormone - blood
Randomized Controlled Trials as Topic - administration & dosage
Renin - blood
Risk Factors - administration & dosage
Sex Factors - administration & dosage
Spironolactone - analogs & derivatives, therapeutic use
Systole - administration & dosage

Find related publications in this database (Keywords)
aldosterone-to-renin ratio
blood pressure
fibroblast growth factor-23
parathyroid hormone
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