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A Reversible Disorder

Terrence W. Diamond, MRCP(UK); J. René Botha, FCS(SA); Jeffrey Wing, FCP(SA); Anthony M. Meyers, FCP(SA); W. John Kalk, MRCP(UK)

Arch Intern Med. 1986;146(9):1709-1712.

Abstract
• A retrospective study of 75 patients who were surgically cured of primary hyperparathyroidism from 1976 to 1984 was performed to evaluate the blood pressure and metabolic responses to parathyroid surgery. Published data on the population prevalence of hypertension (HT) in South Africa were used for comparison. The overall prevalence of HT before surgery was 47%, compared with 23% in the general population. Hypertension was most frequent in patients older than 60 years (62% vs 39% expected). Renal insufficiency was found in 13 of 35 hypertensive patients and in two of 40 normotensive patients. However, the prevalence of HT in patients with normal creatinine levels (37%) exceeded that expected. The frequency of urolithiasis and mean levels of serum and urine calcium and phosphate were similar in normotensive and hypertensive patients. Parathyroidectomy resulted in a substantial fall in both mean systolic and mean diastolic blood pressures in 54% of the hypertensive subjects, unrelated to improvement in renal function.

(Arch Intern Med 1986;146:1709-1712)

Author Affiliations
From the Endocrinology and Metabolism (Drs Diamond, Wing, and Kalk) and Renal Units (Dr Meyers), Department of Medicine and Department of Surgery (Dr Botha), Johannesburg (South Africa) Hospital. Dr Diamond is now with Royal North Shore Hospital, Sydney.

Footnotes
Accepted for publication Nov 19, 1985.

Reprint requests to Department of Medicine, Medical School, Johannesburg Hospital, York Road, Parktown, Johannesburg 2193, South Africa (Dr Kalk).

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