ABSTRACT
Background. Primary hyperparathyroidism (PHPT) is one of the most common endocrine conditions and is accompanied by hypertension and increased cardiovascular mortality. The purpose of this study was to evaluate the effect of parathyroidectomy on systolic and diastolic blood pressure (BP) in hypertensive patients with PHPT and whether hypertension occurs more frequently in PHPT than in control group. Methods. A total of 1020 patients with proved PHPT who underwent surgery were compared with with 1020 age, sex, BMI, and smoking status matched controls. We evaluated changes in serum calcium, parathyroid hormone (PTH), uric acid, and BP before and 6 months after surgery. Results. Parathyroidectomy corrected PHPT and resulted in a substantial fall in both mean systolic (150 ± 3.8 to 138 ± 3.6 mmHg) and mean diastolic pressures (97 ± 3 to 88 ± 2.8 mmHg) of the hypertensive subjects; P < .01. In these patients, PTH, calcium, and uric acid normalized. 726 patients from 1020 with PHPT (69.8%) were found to be hypertensive whilst only 489 (47.8%) from 1020 of our control group. Conclusion. Parathyroidectomy in hypertensive patients reduces systolic and diastolic BP. PHPT is accompanied by a variety of metabolic complications, which are a risk factor for hypertension, and parathyroidectomy can improve these metabolic complications.
ABSTRACT
Care of patients with ischaemic disease of lower extremities (IDLE) in the claudication stage is aimed at the treatment of basal arterial disease and moderation of ischaemia. In apt patients it is necessary to indicate some of revascularization procedures (reconstruction surgery, angioplasty, fibrinolysis). All patients with arterial obliterating disease to observe recommended measures in regimen, consisting of continuous nicotine abstinence and elimination of risk factors for IDLE. These measures together with regular muscle training will in most patients in 2nd stage of IDLE slow down the progression of the disease. Regular check-ups by the attending doctor should early reveal threatening complications. Drug treatment in this stage of IDLE is aimed especially to thrombosis prevention and slowing down of arterial changes and improvement of microcirculation.
