Aortic valve calcification in mild primary hyperparathyroidism.

CONTEXT: It is unclear whether cardiovascular disease is present in primary hyperparathyroidism (PHPT).

OBJECTIVE

Aortic valve structure and function were compared in PHPT patients and population-based controls.

DESIGN

This is a case-control study.

SETTING

The study was conducted in a university hospital metabolic bone disease unit.

PARTICIPANTS

We studied 51 patients with PHPT and 49 controls.

OUTCOME MEASURES: We measured the aortic valve calcification area and the transaortic pressure gradient.

RESULTS

Aortic valve calcification area was significantly higher in PHPT (0.24 ± 0.02 vs. 0.17 ± 0.02 cm(2), p<0.01), although there was no difference in the peak transaortic pressure gradient, a functional measure of valvular calcification (5.6 ± 0.3 vs. 6.0 ± 0.3 mm Hg, P = 0.39). Aortic valve calcification area was positively associated with PTH (r = 0.34; P < 0.05) but not with serum calcium, phosphorus, or 25-hydroxyvitamin D levels or with calcium-phosphate product. Serum PTH level remained an independent predictor of aortic valve calcification area after adjustment for age, sex, body mass index, smoking status, history of hypercholesterolemia and hypertension, and estimated glomerular filtration rate.

CONCLUSIONS

Mild PHPT is associated with subclinical aortic valve calcification. PTH, but not serum calcium concentration, predicted aortic valve calcification. PTH was a more important predictor of aortic valve calcification than well-accepted cardiovascular risk factors.