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Plasma parathyroid hormone and risk of congestive heart failure in the community
Author(s) -
Hagström Emil,
Ingelsson Erik,
Sundström Johan,
Hellman Per,
Larsson Tobias E.,
Berglund Lars,
Melhus Håkan,
Held Claes,
Michaëlsson Karl,
Lind Lars,
Ärnlöv Johan
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq134
Subject(s) - medicine , heart failure , parathyroid hormone , cardiology , left ventricular hypertrophy , vitamin d and neurology , myocardial infarction , hazard ratio , secondary hyperparathyroidism , endocrinology , ejection fraction , hyperparathyroidism , diabetes mellitus , blood pressure , calcium , confidence interval
Aims In experimental studies parathyroid hormone (PTH) has been associated with underlying causes of heart failure (HF) such as atherosclerosis, left ventricular hypertrophy, and myocardial fibrosis. Individuals with increased levels of PTH, such as primary or secondary hyperparathyroidism patients, have increased risk of ischaemic heart disease and HF. Moreover, increasing PTH is associated with worse prognosis in patients with overt HF. However, the association between PTH and the development HF in the community has not been reported. Methods and Results In a prospective, community‐based study of 864 elderly men without HF or valvular disease at baseline (mean age 71 years, the ULSAM study) the association between plasma (P)‐PTH and HF hospitalization was investigated adjusted for established HF risk factors (myocardial infarction, hypertension, diabetes, electrocardiographic left ventricular hypertrophy, smoking, and hypercholesterolaemia) and variables reflecting mineral metabolism (S‐calcium, S‐phosphate, P‐vitamin D, S‐albumin, dietary calcium and vitamin D intake, physical activity, glomerular filtration rate, and blood draw season). During follow‐up (median 8 years), 75 individuals were hospitalized due to HF. In multivariable Cox‐regression analyses, higher P‐PTH was associated with increased HF hospitalization (hazard ratio for 1‐SD increase of PTH, 1.41, 95% CI 1.12–1.77, P = 0.003). Parathyroid hormone also predicted hospitalization in participants without apparent ischaemic HF and in participants with normal P‐PTH. Conclusion In a large community‐based sample of elderly men, PTH predicted HF hospitalizations, also after accounting for established risk factors and mineral metabolism variables. Our data suggest a role for PTH in the development of HF even in the absence of overt hyperparathyroidism.