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Comment & Response
March 11, 2020

Parathyroidectomy and Hypertension

Author Affiliations
  • 1Imperial College London, London, England
JAMA Surg. Published online March 11, 2020. doi:10.1001/jamasurg.2019.6358

To the Editor Graff-Baker et al1 are to be congratulated for their investigation regarding whether parathyroidectomy reverses hypertension in patients with primary hyperparathyroidism (PHPT) compared with nonsurgical patients by assessing changes in mean arterial pressure (MAP) and antihypertensive medication use in their retrospective cohort study. Hypercalcemia and elevated parathyroid hormone levels characterize PHPT, which affects approximately 1% of the population.2 Conflicting evidence exists regarding exact mechanisms of cardiovascular involvement,2 notably hypertension, making it difficult to draw clinically meaningful conclusions. This study1 analyzed 2380 patients for 2 years and reported that surgical patients had lower antihypertensive medication requirements and decreases in MAP. This letter explores improvements to study design and alternative conclusions to increase clinical impact.

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