Primary hyperparathyroidism patients have a 51% increased risk of hip fracture and a 45% increased risk of stroke or heart attack. These are the findings of a large study conducted by the University of Gothenburg in Sweden, which also discovered that surgery is linked to a lower risk of these consequences.

Primary hyperparathyroidism is a frequently diagnosed hormone disorder, particularly among the elderly. It is more common in women, affecting approximately 3 percent of postmenopausal women. It is frequently discovered by chance as the problem does not have any specific symptoms, during blood tests that reveal elevated calcium and elevated or normal parathyroid hormone levels. This abnormal calcium imbalance in the bloodstream can cause kidney, bone, and heart damage.

Previous research has found a connection between primary hyperparathyroidism, cardiovascular disease, and osteoporosis. However, because these studies were few and small, the association has been called into question.

There are numerous complications

This study’s data came from the Swedish National Board of Health and Welfare’s national register, published in the journal JAMA Network Open. Between 2006 and 2017, 16,374 patients had a diagnosis of primary hyperparathyroidism. Each was compared to ten control individuals born in the same year, gender, and county.

Primary hyperparathyroidism, if left untreated, increases the risk of hip fracture by 51% and the risk of heart attack or stroke by 45%. The risk of kidney stones nearly quadruples, as does the risk of death by 72%. Because of the greater probability of these complications, it is critical to identify patients with this hormonal illness.” said  Kristian Axelsson, a scientist at the University of Gothenburg and a general medicine resident in Region Västra Götaland’s public primary care, and the study’s 1st author.

Surgery lowers the risks

The only long-term cure for primary hyperparathyroidism is the surgical removal of the parathyroid glands, either entirely or partially (parathyroidectomy). Patients who meet certain criteria may be candidates for surgery. Those who do not should be closely monitored.

Patients who had surgery had significantly lower risks of hip fracture, stroke, and heart attack according to the researchers.

“The study clearly shows that surgery reduces the risk of fall injuries, osteoporosis fractures, and cardiovascular event death, which are significant findings that could lead to patients being chosen for surgery. Our findings support the view that patients at cardiovascular risk, and high fracture risk, must be considered in surgical decisions,” says Mattias Lorentzon, Senior Author and Professor of Geriatric Medicine, University of Gothenburg.

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