Hyperparathyroidism: complications were common.

Clinical bottom line (level 3b)

  1. Hyperparathyroidism was uncommon in the general population.
  2. Two thirds of patients with hyperparathyroidism had complications and nearly half had hypertension.
Heath et al: New England Journal of Medicine 1980; 302 (4): 189-193
Expires June 2003

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: community-based, region of USA

90 patients (aged range 19 to 92 years; mean 59, 73% female) primary hyperparathyroidism- met one of the following:
  • histopathological proof of parathyroid adenoma or hyperplasia
  • hypercalcaemia and pathognomonic radiographic signs and/or elevated serum immunoreactive parathyroid hormone concentrations
  • hypercalcaemia for more than one year without another cause found after careful evaluation




Outcomes studied:
  • complications or concomitants of hyperparathyroidism
  • definite hypertension

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    complications or concomitants of hyperparathyroidism ? 57/90 63.3%
    (53.4% to 73.3%)
    definite hypertension ? 43/90 47.8%
    (37.5% to 58.1%)

    • The incidence of hyperparathyroidism was much higher after routine measurement of serum calcium was introduced.

    Citation

    1. Heath H, Hodgson SF, Kennedy MA: Primary hyperparathyroidism: Incidence, morbidity, and potential economic impact in a community. New England Journal of Medicine 1980; 302 (4): 189-193
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer:

    Clinical Question.
    Patient community
    Intervention or Exposure prevalence
    Outcome primary hyperparathyroidism