Heart Health Worsened in Pts With Chronic Hypoparathyroidism
Patients with chronic hypoparathyroidism faced a significantly higher risk for cardiovascular diseases and mortality from cardiovascular causes than control individuals without the condition, with the effect being particularly prominent among women.
METHODOLOGY:
Researchers conducted this study by merging data from population-based registries in Sweden to assess the risk for cardiovascular diseases in patients with chronic hypoparathyroidism.
They included 1982 patients with chronic hypoparathyroidism (mean age, 54.7 years; 76.7% women) and matched them to 19,494 control individuals without the condition.
The median follow-up time was 9.09 years for patients with chronic hypoparathyroidism and 8.91 years for control individuals.
The outcome was the presence of at least one cardiovascular event such as acute myocardial infarction, atrial fibrillation/flutter, heart failure, valvular heart disease, peripheral artery disease, or stroke or transient ischaemic attack; fatal cardiovascular disease was defined as death from any cardiovascular causes.
TAKEAWAY:
Patients with chronic hypoparathyroidism showed higher risks for valvular heart disease (hazard ratio [HR], 2.08; 95% CI, 1.67-2.60), peripheral artery disease (HR, 1.78; 95% CI, 1.41-2.26), heart failure (HR, 1.66; 95% CI, 1.44-1.90), atrial fibrillation/flutter (HR, 1.58; 95% CI, 1.38-1.81), and acute myocardial infarction (HR, 1.31; 95% CI, 1.05-1.64) than control individuals.
The risk for fatal cardiovascular disease was 59% higher in patients with chronic hypoparathyroidism than in control individuals (HR, 1.59; 95% CI, 1.40-1.80).
Women with chronic hypoparathyroidism showed significantly higher risks for valvular heart disease, peripheral artery disease, heart failure, atrial fibrillation, myocardial infarction, and fatal cardiovascular disease than their matched control individuals; however, no significant differences in any cardiovascular outcomes were observed between men with chronic hypoparathyroidism and their matched control individuals.
The increased risk for cardiovascular diseases in patients with chronic hypoparathyroidism remained consistent, regardless of the surgical or non-surgical aetiology of chronic hypoparathyroidism.
IN PRACTICE:
"[The study] findings highlight the need for close monitoring and preventive management of cardiovascular risk factors, particularly in women," the authors wrote.
SOURCE:
This study was led by Sigridur Björnsdottir, MD, PhD, Karolinska Institutet, Stockholm, Sweden. It was published online on April 28, 2025, in The Journal of Clinical Endocrinology & Metabolism .
LIMITATIONS:
This study lacked data on biochemical measures, physical activity, height, body weight, and blood pressure and relied on chronic obstructive pulmonary disease as a proxy variable for heavy smoking. Information about dosages of active vitamin D, calcium, and levothyroxine was not available in the registries.
DISCLOSURES:
This study was supported by a research grant from the Swedish Research Council, Knut and Alice Wallenberg Foundation, Novo Nordisk Foundation, Torsten and Ragnar Söderberg's Foundations, and Kristian Gerhard Jebsen Foundation. Several authors reported serving as research investigators, members of the advisory board and steering committees, and consultants and receiving research grants, consultancy fees, and personal fees from various pharmaceutical companies.
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