Advertisement

The clinical investigator

, Volume 70, Issue 9, pp 748–751 | Cite as

Disturbed calcium metabolism in subjects with elevated diastolic blood pressure

  • H. Reichel
  • R. Liebethal
  • H. -W. Hense
  • H. Schmidt-Gayk
  • E. Ritz
Original Article

Summary

Essential hypertension has been associated with disturbed calcium metabolism, but the available data are controversial. We measured parameters of calcium metabolism in groups of untreated male subjects (n = 78) with elevated diastolic blood pressure (101 ± 6 mmHg, mean ± SD) and age-matched male subjects (n=79) with low diastolic blood pressure (62 ± 4 mmHg). The participants of the study were drawn from a random population sample. Subjects with high diastolic blood pressure had significantly higher carboxy-terminal parathyroid hormone (PTH) plasma concentrations than controls with low diastolic blood pressure (median 114 vs. 43 pmol/l, P < 0.01). The 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations were comparable in both groups. Individuals with high diastolic blood pressure had significantly lower total serum calcium (2.41 ± 0.10 vs. 2.47 ± 0.10 mmol/l, mean ± SD; P < 0.01). PTH concentrations were correlated with diastolic pressure (r = −0.39, P < 0.001). The data are compatible with increased parathyroid activity despite unchanged concentrations of vitamin D metabolites in human hypertension.

Key words

Hypertension Calcium Parathyroid hormone 1,25-Dihydroxyvitamin D3 

Abbreviations

PTH

parathyroid hormone

C-PTH

carboxy-terminal parathyroid hormone

1,25(OH)2D

1,25-di-hydroxyvitamin D

25(OH)D

25-hydroxyvitamin D

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bishop JE Norman AW, Coburn JW, Roberts PA, Henry HL (1980) 25-Hydroxyvitamin D3, 24, 25-dihydroxyvitamin D and 1,25-dihydroxyvitamin D in a single two-milliliter plasma sample. Miner Electrolyte Metab 3: 235–243.Google Scholar
  2. 2.
    Coe FL, Canterbury JM, Firpo JJ, Reiss E (1973) Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria. J Clin Invest 52: 134–142.CrossRefGoogle Scholar
  3. 3.
    Forero MS, Klein RF, Nissenson RA, Nelson K, Heath H III, Arnaud CD, Riggs BL (1987) Effect of age on circulating immunoreactive and bioactive parathyroid hormone levels in women. J Bone Miner Res 2: 363–366.CrossRefGoogle Scholar
  4. 4.
    Fournier A, Coevoet B, De Fremont JF, et al (1978) Propranolol therapy for secondary hyperparathyroidism in uraemia. Lancet II: 50–51.CrossRefGoogle Scholar
  5. 5.
    Hughes GS Jr, Oexmann RD, Margolius HS, Epstein S, Bell NH (1988) Normal vitamin D and mineral metabolism in essential hypertension. Am J Med Sci 296: 252–259.CrossRefGoogle Scholar
  6. 6.
    Hvarfner A, Bergström R, Mörlin C, Wide L, Ljunghall S (1987) Relationships between calcium metabolism indices and blood pressure in patients with essential hypertension as compared with a healthy population. J Hypertens 5: 451–456.CrossRefGoogle Scholar
  7. 7.
    Keil U, Stieber J, Döring A, Chambless L, Härtel U, Filipiak B, Hense HW, Tietze M, Gostomzyk JG (1989) The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85. Acta Med Scand Suppl 728: 119–128.Google Scholar
  8. 8.
    Kesteloot H, Joossens JV (1988) Relationship of serum sodium, potassium, calcium, and phosphorus with blood pressure. Hypertension 12: 589–593.CrossRefGoogle Scholar
  9. 9.
    McCarron DA (1982) Low serum concentrations of ionized calcium in patients with hypertension. N Engl J Med 307: 226–228.CrossRefGoogle Scholar
  10. 10.
    McCarron DA, Pingree PA, Rubin RJ, Gaucher SM, Molitch M, Krutzik S (1980) Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak. Hypertension 2: 162–168.CrossRefGoogle Scholar
  11. 11.
    Reichel H, Deibert B, Schmidt-Gayk H, Ritz E (1991) Calcium metabolism in early chronic renal failure. Implications for pathogenesis of hyperparathyroidism. Nephrol Dial Transplant 6: 162–169.CrossRefGoogle Scholar
  12. 12.
    Reichel H, Deibert B, Geberth S, Schmidt-Gayk H, Ritz E (1992) Frusemide therapy and intact parathyroid hormone concentrations in chronic renal insufficiency. Nephrol Dial Transplant 7: 8–15.PubMedGoogle Scholar
  13. 13.
    Resnick LM, Muller FB, Laragh JH (1986) Calcium-regulating hormones in essential hypertension. Relation to plasma renin activity and sodium metabolism. Ann Int Med 105: 649–654.CrossRefGoogle Scholar
  14. 14.
    Scharla S, Schmidt-Gayk H, Reichel H, Mayer E (1984) A sensitive and simplified radioimmunoassay for 1,25-dihydroxyvitamin D3. Clin Chim Acta 142: 325–334.CrossRefGoogle Scholar
  15. 15.
    Sowers MFR, Wallace RB, Hollis BW, Lemke JH (1988) Relationship between 1,25-dihydroxyvitamin D3 and blood pressure in a geographically defined population. Am J Clin Nutr 48: 1053–1056.CrossRefGoogle Scholar
  16. 16.
    Strazzullo P, Nunziata V, Cirillo M, Giannattasio R, Ferrara LA, Mattioli PL, Mancini M (1983) Abnormalities of calcium metabolism in essential hypertension. Clin Sci 65: 137–141.CrossRefGoogle Scholar
  17. 17.
    Tillmann DM, Semple PF (1988) Calcium and magnesium in essential hypertension. Clin Sci 75: 395–402.CrossRefGoogle Scholar
  18. 18.
    Young EW, Dolney AM, McCarron DA, Morris CD (1988) Serum 1,25(OH)2 vitamin D3 in essential hypertension (abstract). Am J Hypertens 1: 75A.Google Scholar
  19. 19.
    Zillikens D, Armbruster FP, Stern J, Schmidt-Gayk H, Raue F (1987) Sensitive homologous radioimmunoassay for human parathyroid hormone to diagnose hypoparathyroid conditions. Ann Clin Biochem 24: 608–613.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • H. Reichel
    • 3
  • R. Liebethal
    • 3
  • H. -W. Hense
    • 1
  • H. Schmidt-Gayk
    • 2
  • E. Ritz
    • 3
  1. 1.GSF/Medis InstitutMünchen-NeuherbergGermany
  2. 2.HormonlaborHeidelbergGermany
  3. 3.Medizinische Klinik der Universität Heidelberg Sektion NephrologieHeidelbergGermany

Personalised recommendations