Primary hyperparathyroidism (PHP) is associated with a high incidence of various cardiovascular diseases, particularly arterial hypertension. The strategy for selecting antihypertensive therapy in patients with hypercalcemia does not differ from that in patients with normal serum calcium concentration. However, the pathogenetic mechanisms of arterial hypertension in PHP suggest a possible advantage in achieving normotension with antihypertensive drugs of certain groups.

OBJECTIVE

To study the spectrum of antihypertensive drugs used in patients with PHP.

MATERIAL AND METHODS

The study was conducted at the National Medical Research Center for Endocrinology from January 2017 to December 2021. The study included patients hospitalized for confirmed PHP. All patients were examined and treated according to current standards of care and clinical guidelines.

RESULTS

The study included 585 patients with PHP, of whom 397 had hypertension. Patients were divided into four groups according to the number of antihypertensive drugs taken: group A — no therapy, group B — one drug, group C — two drugs, group D — three drugs or more. Group D patients were statistically significantly older and had lower glomerular filtration rates and higher calcium blood levels than group A patients. These patterns were not present in the cohort of patients aged 40—55 years without renal dysfunction or carbohydrate metabolism disorders. When analyzing drug prescriptions, it was found that patients with hypertension required treatment escalation and a change of antihypertensive drugs.

CONCLUSION

The present study demonstrated an association between hypercalcemia and the intensity of antihypertensive therapy in patients with primary hyperparathyroidism. However, the pathogenetic basis of this observation needs to be clarified. Some drugs may have additional benefits in treating patients with primary hyperparathyroidism, but further studies are needed to verify these effects.