PTH and arterial hypertension

Abstract

Parathormon (PTH) has been recognized as a potential factor in the etiopathogenesis of essential hypertension. The higher prevalence of arterial hypertention in primary hyperparathyroidism (pHPT) than in the general population and higher serum PTH concetration in patients with essential hypertensive are the only indirect evidence confirming this assumption. Infusion of PTH in man results in transient vasodilatation and increased urinary sodium excretion that gives evidence against its hypertensive effect. On the contrary, impaired endothelial function, proliferation of vascular smooth cells and heart hypertrophy may cause increase of blood pressure. Question concerning the role of PTH in the pathogenesis of arterial hypertension arises when excretory renal function, which is often impaired not only in patients with pHPT but also with arterial hypertension as a result of hypertensive nephropathy and ageing, is taken under consideration. It is important to remember about the negative consequences of long-term kidney exposition to increased PTH and serum calcium level in patients with pHPT. However, the role of PTH in the etiopathogenesis of arterial hypertension is still unclear, pHPT is undoubtedly associated with increased cardiovascular risk.
The aim of this critical review is to summarize current arguments concerning the relationship between PTH and arterial hypertension.