Grobbee D E, Hackeng W H, Birkenhäger J C, Hofman A
Department of Epidemiology, Erasmus University Medical School, Rotterdam, The Netherlands.
Br Med J (Clin Res Ed). 1988 Mar 19;296(6625):814-6. doi: 10.1136/bmj.296.6625.814.
To study the role of parathyroid gland activity in early primary hypertension plasma concentrations of intact parathyroid hormone were measured in 90 untreated young subjects, aged 16-29, with stable midly raised blood pressure and in 40 normotensive control subjects selected from the same population in Zoetermeer, The Netherlands. Intact parathyroid hormone concentration was significantly higher in the hypertensive than the normotensive group (2.34 (SE 0.11) pmol/l v 1.47 (0.13) pmol/l, respectively; difference 0.87 pmol/l; 95% confidence interval 0.55 to 1.21; p less than 0.0001). Serum total calcium concentration was 2.36 (0.01) mmol/l in the hypertensive group and 2.42 (0.01) mmol/l in the normotensive group (difference 0.06 mmol/l; 95% confidence interval 0.02 to 0.09; p = 0.02). Urinary calcium excretion over 24 hours did not differ significantly between the two groups (4.17 (0.28) mmol/24 h in the hypertensive group and 3.89 (0.39) mmol/24 h in the normotensive group; difference 0.28 mmol/24 h; 95% confidence interval -0.66 to 1.22). In the hypertensive group both systolic and diastolic blood pressures increased slightly though significantly with intact parathyroid hormone concentrations. No obvious associations between serum calcium concentration and blood pressure were observed. These findings support the view that enhanced activity of the parathyroid gland may play a part in the early stage of primary hypertension.
为研究甲状旁腺活动在早期原发性高血压中的作用,对90名年龄在16 - 29岁、血压稳定且轻度升高的未经治疗的年轻受试者,以及从荷兰祖特梅尔同一人群中选取的40名血压正常的对照受试者,测量了其血浆中完整甲状旁腺激素的浓度。高血压组的完整甲状旁腺激素浓度显著高于血压正常组(分别为2.34(标准误0.11)pmol/l和1.47(0.13)pmol/l;差值0.87 pmol/l;95%置信区间0.55至1.21;p小于0.0001)。高血压组血清总钙浓度为2.36(0.01)mmol/l,血压正常组为2.42(0.01)mmol/l(差值0.06 mmol/l;95%置信区间0.02至0.09;p = 0.02)。两组24小时尿钙排泄量无显著差异(高血压组为4.17(0.28)mmol/24小时,血压正常组为3.89(0.39)mmol/24小时;差值0.28 mmol/24小时;95%置信区间 - 0.66至1.22)。在高血压组中,收缩压和舒张压均随完整甲状旁腺激素浓度的升高而略有但显著升高。未观察到血清钙浓度与血压之间有明显关联。这些发现支持甲状旁腺活动增强可能在原发性高血压早期起作用这一观点。