Secondary hyperparathyroidism is associated with postpartum blood pressure in preeclamptic women and normal pregnancies.


Journal

Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882

Informations de publication

Date de publication:
01 03 2021
Historique:
pubmed: 9 10 2020
medline: 16 10 2021
entrez: 8 10 2020
Statut: ppublish

Résumé

Preeclampsia has been associated with features of secondary hyperparathyroidism. In this study, we examine the relationships of calcium metabolism with blood pressure (BP) in preeclamptic women and in a control group of normal (NORM) pregnancies in the postpartum. Sixty-three consecutive preeclamptic women (age 35 ± 6 years) were studied 4 weeks after delivery. We collected clinical and lab information on pregnancy and neonates and measured plasma and urinary calcium and phosphate, plasma parathyroid hormone (PTH) and 25-hydroxy vitamin D [25(OH)D], and performed 24-h ambulatory BP monitoring. BP and calcium metabolism of 51 preeclamptic were compared with 17 NORM pregnant women that matched for age, race, and postpartum BMI. 25(OH)D deficiency (<10 ng/ml) was found in 3% of preeclamptic women, insufficiency (10-30 ng/ml) in 67%, and NORM values (31-100 ng/ml) in the remaining 30%. Elevated plasma PTH (≥79 pg/ml) was found in 24% of preeclamptic women who had 25(OH)D plasma levels of 21.4 ± 8.3 ng/ml. In these women, PTH levels was independently associated with 24-h SBP and DBP and daytime and night-time DBP. Prevalence of nondippers and reverse dippers was elevated (75% and 33%, respectively). No associations between calcium metabolism and neonates' characteristics of preeclamptic women were observed. Prevalence of vitamin D deficiency and insufficiency and of elevated plasma PTH levels were comparable in matched groups. Considering preeclamptic women and matched controls as a whole group, office SBP and DBP levels were associated with PTH independently of preeclampsia and other confounders. Features of secondary hyperparathyroidism are common in the postpartum. Preeclampsia and increased PTH levels were both independent factors associated with increased BP after delivery, and both might affect the future cardiovascular risk of these women.

Sections du résumé

BACKGROUND
Preeclampsia has been associated with features of secondary hyperparathyroidism. In this study, we examine the relationships of calcium metabolism with blood pressure (BP) in preeclamptic women and in a control group of normal (NORM) pregnancies in the postpartum.
METHODS
Sixty-three consecutive preeclamptic women (age 35 ± 6 years) were studied 4 weeks after delivery. We collected clinical and lab information on pregnancy and neonates and measured plasma and urinary calcium and phosphate, plasma parathyroid hormone (PTH) and 25-hydroxy vitamin D [25(OH)D], and performed 24-h ambulatory BP monitoring. BP and calcium metabolism of 51 preeclamptic were compared with 17 NORM pregnant women that matched for age, race, and postpartum BMI.
RESULTS
25(OH)D deficiency (<10 ng/ml) was found in 3% of preeclamptic women, insufficiency (10-30 ng/ml) in 67%, and NORM values (31-100 ng/ml) in the remaining 30%. Elevated plasma PTH (≥79 pg/ml) was found in 24% of preeclamptic women who had 25(OH)D plasma levels of 21.4 ± 8.3 ng/ml. In these women, PTH levels was independently associated with 24-h SBP and DBP and daytime and night-time DBP. Prevalence of nondippers and reverse dippers was elevated (75% and 33%, respectively). No associations between calcium metabolism and neonates' characteristics of preeclamptic women were observed. Prevalence of vitamin D deficiency and insufficiency and of elevated plasma PTH levels were comparable in matched groups. Considering preeclamptic women and matched controls as a whole group, office SBP and DBP levels were associated with PTH independently of preeclampsia and other confounders.
CONCLUSION
Features of secondary hyperparathyroidism are common in the postpartum. Preeclampsia and increased PTH levels were both independent factors associated with increased BP after delivery, and both might affect the future cardiovascular risk of these women.

Identifiants

pubmed: 33031174
pii: 00004872-202103000-00024
doi: 10.1097/HJH.0000000000002638
doi:

Substances chimiques

Parathyroid Hormone 0
Vitamin D 1406-16-2
Calcium SY7Q814VUP

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

563-572

Informations de copyright

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Références

Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, et al. US Preventive Services Task Force. Screening for preeclampsia: US Preventive Services Task Force Recommendation Statement. JAMA 2017; 317:1661–1667.
Pitkin RM. Calcium metabolism in pregnancy and the perinatal period: a review. Am J Obstet Gynecol 1985; 151:99–109.
Wheeler BJ, Taylor BJ, de Lange M, Harper MJ, Jones S, Mekhail A, Houghton LA. A longitudinal study of 25-hydroxy vitamin D and parathyroid hormone status throughout pregnancy and exclusive lactation in New Zealand mothers and their infants at 45° S. Nutrients 2018; 10:E86.
Scholl TO, Chen X, Stein TP. Vitamin D, secondary hyperparathyroidism, and preeclampsia. Am J Clin Nutr 2013; 98:787–793.
Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2019; 7:CD008873.
Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2018; CD001059.
Saleh F, Jorde R, Sundsfjord J, Haug E, Figenschau Y. Causes of secondary hyperparathyroidism in a healthy population: the Tromsø study. J Bone Miner Metab 2006; 24:58–64.
Komaba H, Kakuta T, Fukagawa M. Diseases of the parathyroid gland in chronic kidney disease. Clin Exp Nephrol 2011; 15:797–809.
Hagström E, Hellman P, Larsson TE, Ingelsson E, Berglund L, Sundström J, et al. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation 2009; 119:2765–2771.
Fujii H. Association between parathyroid hormone and cardiovascular disease. Ther Apher Dial 2018; 22:236–241.
Hagström E, Michaëlsson K, Melhus H, Hansen T, Ahlström H, Johansson L, et al. Plasma-parathyroid hormone is associated with subclinical and clinical atherosclerotic disease in 2 community-based cohorts. Arterioscler Thromb Vasc Biol 2014; 34:1567–1573.
Jorde R, Bonaa KH, Sundsfjord J. Population based study on serum ionised calcium, serum parathyroid hormone, and blood pressure. The Tromsø study. Eur J Endocrinol 1999; 141:350–357.
Lykke JA, Langhoff-Roos J, Sibai BM, Funai EF, Triche EW, Paidas MJ. Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother. Hypertension 2009; 53:944–951.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. Authors/Task Force Member. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018; 36:1953–2041.
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 2018; 39:3165–3241.
Veerbeek JHW, Hermes W, Breimer AY, van Rijn BB, Koenen SV, Mol BW, et al. Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension. Hypertension 2015; 65:600–606.
Bertino E, Spada E, Occhi L, Coscia A, Giuliani F, Gagliardi L, et al. Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr 2010; 51:353–361.
Payne RB, Little AJ, Evans RT. Albumin-adjusted calcium concentration in serum increases during normal pregnancy. Clin Chem 1990; 36:142–144.
Murphy MM, Scott JM, McPartlin JM, Fernandez-Ballart JD. The pregnancy-related decrease in fasting plasma homocysteine is not explained by folic acid supplementation, hemodilution, or a decrease in albumin in a longitudinal study. Am J Clin Nutr 2002; 76:614–619.
Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal serum proteins. BMJ 1973; 4:643–646.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang Y, Hendriksen S, et al. Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 2006; 145:247–254.
Colussi G, Catena C, Dialti V, Pezzutto F, Mos L, Sechi LA. Fish meal supplementation and ambulatory blood pressure in patients with hypertension: relevance of baseline membrane fatty acid composition. Am J Hypertens 2014; 27:471–481.
Ho D, Imai K, King G, Stuart EA. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw 2011; 42:1–28.
Hemmingway A, Kenny LC, Malvisi L, Kiely ME. Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes. Am J Clin Nutr 2018; 108:821–829.
Staessen JA, Bieniaszewski L, O’Brien E, Gosse P, Hayashi H, Imai Y, et al. Nocturnal blood pressure fall on ambulatory monitoring in a large international database. The ‘Ad Hoc’ Working Group. Hypertension 1997; 29:30–39.
Saremi AT, Shafiee MA, Montazeri M, Rashidi N, Montazeri M. Blunted overnight blood pressure dipping in second trimester; a strong predictor of gestational hypertension and preeclampsia. Curr Hypertens Rev 2019; 15:70–75.
Benschop L, Duvekot JJ, Versmissen J, van Broekhoven V, Steegers EAP, Roeters van Lennep JE. Blood pressure profile 1 year after severe preeclampsia. Hypertension 2018; 71:491–498.
Behrens I, Basit S, Melbye M, Lykke JA, Wohlfahrt J, Bundgaard H, et al. Risk of postpregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study. BMJ 2017; 358:j3078.
Riise HKR, Sulo G, Tell GS, Igland J, Egeland G, Nygard O, et al. Hypertensive pregnancy disorders increase the risk of maternal cardiovascular disease after adjustment for cardiovascular risk factors. Int J Cardiol 2019; 282:81–87.
Lui NA, Jeyaram G, Henry A. Postpartum interventions to reduce long-term cardiovascular disease risk in women after hypertensive disorders of pregnancy: a systematic review. Front Cardiovasc Med 2019; 6:160.
Hofmeyr GJ, Seuc AH, Betrán AP, Purnat TD, Ciganda A, Munjanja SP, et al. Calcium and Preeclampsia Study Group. The effect of calcium supplementation on blood pressure in nonpregnant women with previous preeclampsia: an exploratory, randomized placebo controlled study. Pregnancy Hypertens 2015; 5:273–279.
Achkar M, Dodds L, Giguère Y, Forest J-C, Armson BA, Woolcott C, et al. Vitamin D status in early pregnancy and risk of preeclampsia. Am J Obstet Gynecol 2015; 212:511.e1–511.e7.
Schoenaker DAJM, Soedamah-Muthu SS, Mishra GD. The association between dietary factors and gestational hypertension and preeclampsia: a systematic review and meta-analysis of observational studies. BMC Med 2014; 12:157.
Hofmeyr GJ, Manyame S. Calcium supplementation commencing before or early in pregnancy, or food fortification with calcium, for preventing hypertensive disorders of pregnancy. Cochrane Database Syst Rev 2017; 9:CD011192.
Khaing W, Vallibhakara SA-O, Tantrakul V, Vallibhakara O, Rattanasiri S, McEvoy M, et al. Calcium and vitamin D supplementation for prevention of preeclampsia: a systematic review and network meta-analysis. Nutrients 2017; 9:E1141.
Nieto A, Herrera JA, Villar J, Matorras R, López de la Manzanara C, Arribas I, et al. Association between calcium intake, parathormone levels and blood pressure during pregnancy. Colomb Médica 2009; 40:185–193.
Pal A, Roy D, Adhikary S, Roy A, Dasgupta M, Mandal AK. A prospective study for the prediction of preeclampsia with urinary calcium level. J Obstet Gynaecol India 2012; 62:312–316.
McMaster KM, Kaunitz AM, Burbano de Lara P, Sanchez-Ramos L. A systematic review and meta-analysis of hypocalciuria in preeclampsia. Int J Gynaecol Obstet 2017; 138:3–11.
Taufield PA, Ales KL, Resnick LM, Druzin ML, Gertner JM, Laragh JH. Hypocalciuria in preeclampsia. N Engl J Med 1987; 316:715–718.
Frenkel Y, Barkai G, Mashiach S, Dolev E, Zimlichman R, Weiss M. Hypocalciuria of preeclampsia is independent of parathyroid hormone level. Obstet Gynecol 1991; 77:689–691.

Auteurs

GianLuca Colussi (G)

Hypertension Unit, Division of Internal Medicine.

Cristiana Catena (C)

Hypertension Unit, Division of Internal Medicine.

Lorenza Driul (L)

Division of Obstetrics and Gynecology.

Francesca Pezzutto (F)

Hypertension Unit, Division of Internal Medicine.

Valentina Fagotto (V)

Hypertension Unit, Division of Internal Medicine.

Daniele Darsiè (D)

Hypertension Unit, Division of Internal Medicine.

Gretta V Badillo-Pazmay (GV)

Hypertension Unit, Division of Internal Medicine.

Giulio Romano (G)

Division of Nephrology.

Paola E Cogo (PE)

Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy.

Leonardo A Sechi (LA)

Hypertension Unit, Division of Internal Medicine.

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