Effect of Parathyroidectomy on Control of Blood Pressure in Hypertensive Patients with Primary Hyperparathyroidism.

Principal Investigator: Shaghayegh Aliabadi, MD
Co-Investigator(s): Richard Jamison, MD, Earl Schuman, MD, Elizabeth Stephens, MD

The objective of this study is to evaluate the potential benefit in regards to blood pressure control in patients undergoing parathyroidectomy. Enrollment began October 1, 2010.

To inquire about participation in the study, please contact 503-963-2935.

Study Overview: Patients with primary hyperparathyroidism have a significantly increased risk of osteoporosis, renal stones, neurocognitive dysfunction, glucose intolerance and cardiovascular disease including hypertension, congestive heart failure, myocardial infarction, left ventricular hypertrophy and death.

The beneficial effects of early parathormone and calcium correction have been demonstrated on bone health, renal stone formation and psychosomatic symptoms in patients with even mild disease. However, both the mechanism for increased cardiovascular morbidity and mortality as well as the role of surgery in ameliorating these outcomes is not well understood. While the hypercalcemic state has been directly implicated as the source of the cardiovascular morbidity, others have suggested an independent effect of the parathyroid hormone on other endocrine cascades which lead to hypertension and cardiac disease. Furthermore there are conflicting data regarding improvement in post parathyroidectomy blood pressures, despite a demonstrable decrease in cardiac risks including MI and death.

Patients referred by other physicians will be identified by surgeons (study investigators) at the preoperative clinic visit. The investigator will present this study treatment option and IRB approved informed consent document to potential candidates. Each potential subject will be provided with written informed consent prior to any research-related procedure and will be given ample opportunity to ask questions and consider participation. If the patient chooses to take part, the patient will sign the current IRB approved consent form and will be given a copy of it for his/her records. For the duration of the study, the patient will be provided with a home blood pressure machine. Participants will monitor their blood pressure at home, in a more natural setting, the week proceeding and following surgery, then again for a week six month postoperatively. If a patient declines participation in the study, they will be offered the choice of proceeding with parathyroidectomy without home blood pressure monitoring. All informed consent discussions with the patient will be documented.