Endocrine Abstracts

Introduction: Primary hyperparathyroidism is associated with numerous cardiovascular complications including hypertension, left ventricular hypertrophy and calcification of cardiac valves. However NICE have not included cardiovascular complications as an indication of parathyroidectomy. This literature review will be focused on benefits of parathyroidectomy on cardiovascular complications of primary hyperparathyroidism.

Methodology: Literature search done through use of search engines google scholar, PubMed, Cochrane database, Medline and EmBase using PRISMA model. Initial database search revealed 79 studies. After applying exclusion and inclusion criterion, 43 studies were finalized for systemic review.

Results: Amongst the cardiovascular complication of 1PHPT hypertension and LVH are most investigated in literature ad evidence is relatively strong for hypertension and LVH compared to other cardiovascular complications. Evidence is relatively weak for coronary artery disease, serum lipid profile, endothelial vasodilatory dysfunction, calcification of cardiac valves, occurrence of cardiovascular events and cardiovascular mortality.

Conclusions: Although evidence of benefits of parathyroidectomy for HTN and LVH is relatively strong, lack of well-designed multicentre randomized control trial seems to be the main obstacle for inclusion of this as part of parathyroidectomy criterion. However, there is a rationale on basis of evidence available to include Hypertension and LVH as possible indications. Consideration should be given for inclusion of echocardiogram at baseline and follow up of 1PHPT patients managed conservatively.