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Observational Study
. 2025 Mar 27;192(4):373-384.
doi: 10.1093/ejendo/lvaf023.

Cardiovascular status in chronic hypoparathyroidism: a systematic cross-sectional assessment in 168 patients

Carmina Teresa Fuss  1 , Karen Gronemeyer  1 , Franca Hermes  1 , Marcus Dörr  2   3 , Benedikt Schmid  4 , Caroline Morbach  5 , Lena Schmidbauer  6 , Nicolas Schlegel  7 , Martin Fassnacht  1 , Ann Cathrin Koschker  1 , Peter Nordbeck  8 , Anke Hannemann  2   9 , Stefanie Hahner  1
Affiliations
Observational Study

Cardiovascular status in chronic hypoparathyroidism: a systematic cross-sectional assessment in 168 patients

Carmina Teresa Fuss et al. Eur J Endocrinol. .

Abstract

Objective: Long-term complications such as renal diseases are well known in patients with chronic hypoparathyroidism (hypoPT), but risk of cardiovascular comorbidity remains less clear. This study comprehensively assessed cardiovascular parameters in hypoPT compared to matched controls.

Design: Cross-sectional cohort study involving 168 patients with chronic hypoPT.

Methods: Patients underwent electrocardiograms, blood pressure measurements, and echocardiography. A 1:3 propensity score matching was performed with individuals from the German population-based Study of Health in Pomerania (SHIP-TREND) and the "Characteristics and Course of Heart Failure Stages A-B" (STAAB) cohort.

Results: HypoPT showed significantly higher systolic (128 vs 125 mm Hg, P = .02) and diastolic blood pressures (83 vs 77 mm Hg, P < .01). Intake of antihypertensives was similar between groups. The QTc interval was markedly prolonged (438 vs 420 ms, P < .01) with QTc interval prolongation occurring significantly more frequently in hypoPT (24% vs 6%, P < .01). Interestingly, echocardiography revealed significantly lower left ventricular mass index (28 vs 43 g/m2.7, P < .01) and less frequent left ventricular hypertrophy (7%% vs 41%, P < .01) in hypoPT but comparable left ventricular ejection fraction (P = .48). HypoPT patients had higher prevalence of mitral (20 vs 0%, P < .01) and aortic valve stenoses (7 vs 2%, P < .01). Comparison with STAAB confirmed the increased prevalence of arterial hypertension and reduced myocardial mass indices.

Conclusions: Patients with hypoPT exhibit a higher prevalence of QTc interval prolongation despite established therapy and an increased incidence of hypertension. Conversely, echocardiography revealed lower left ventricular mass and less frequent left ventricular hypertrophy in hypoPT, but higher prevalence of valve stenosis. Regular monitoring of hypertension, QTc interval prolongation, and valve stenosis is recommended to reduce the risk of cardiovascular diseases.

Clinical trial registration number: NCT05585593.

Keywords: blood pressure; cardiac function; echocardiography; hypoparathyroidism.

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Conflict of interest statement

Conflict of interest: CTF: local investigator (Amolyt), SH: member of the Paradighm-registry advisory board (Takeda), speaker (Ascendis), local investigator (Amolyt), no personal fees. Remaining authors: none declared.

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