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Parathyroid hormone concentration and risk of cardiovascular diseases: The Atherosclerosis Risk in Communities (ARIC) study

Background According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and ot...

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Published in:The American heart journal 2014-09, Vol.168 (3), p.296-302
Main Authors: Folsom, Aaron R., MD, Alonso, Alvaro, MD, PhD, Misialek, Jeffrey R., MPH, Michos, Erin D., MD, Selvin, Elizabeth, PhD, Eckfeldt, John H., MD, PhD, Coresh, Josef, MD, PhD, Pankow, James S., PhD, Lutsey, Pamela L., PhD
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cited_by cdi_FETCH-LOGICAL-c670t-f42df87f23c5850a77d95adb8c98e8cd85e2fd5ea94b6a6ea85549ca434766603
cites cdi_FETCH-LOGICAL-c670t-f42df87f23c5850a77d95adb8c98e8cd85e2fd5ea94b6a6ea85549ca434766603
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container_title The American heart journal
container_volume 168
creator Folsom, Aaron R., MD
Alonso, Alvaro, MD, PhD
Misialek, Jeffrey R., MPH
Michos, Erin D., MD
Selvin, Elizabeth, PhD
Eckfeldt, John H., MD, PhD
Coresh, Josef, MD, PhD
Pankow, James S., PhD
Lutsey, Pamela L., PhD
description Background According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding variables. Methods The ARIC study measured PTH using a second-generation assay (Roche, Indianapolis, IN) in stored serum samples from 1990 to 1992 and related levels in 10,392 adults to incident cardiovascular outcomes (coronary heart disease [n = 808], heart failure [n = 1,294], stroke [n = 586], peripheral artery disease [n = 873], atrial fibrillation [n = 1,190], and CVD mortality [n = 647]) through 2010 (median follow-up 19 years). Results Contrary to the hypothesis, PTH level was not associated positively with any CVD outcome. The associations of incident heart failure, peripheral artery disease, and CVD mortality with PTH actually were weakly inverse ( P trend = .02-.04) in the most fully adjusted models. For example, the hazard ratios across PTH quartiles were 1.00, 1.07, 1.07, and 0.96 ( P trend = .74) for coronary heart disease incidence and were 1.00, 0.69, 0.74, and 0.74 ( P trend = .02) for CVD mortality. Patterns were similar when restricted to participants with normal baseline kidney function. Conclusions This large prospective study failed to support the hypothesis that elevated PTH is an independent risk marker for incident CVD. When our data were added to the previous meta-analysis, the pooled hazard ratio remained statistically significant but weakened.
doi_str_mv 10.1016/j.ahj.2014.04.017
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We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding variables. Methods The ARIC study measured PTH using a second-generation assay (Roche, Indianapolis, IN) in stored serum samples from 1990 to 1992 and related levels in 10,392 adults to incident cardiovascular outcomes (coronary heart disease [n = 808], heart failure [n = 1,294], stroke [n = 586], peripheral artery disease [n = 873], atrial fibrillation [n = 1,190], and CVD mortality [n = 647]) through 2010 (median follow-up 19 years). Results Contrary to the hypothesis, PTH level was not associated positively with any CVD outcome. The associations of incident heart failure, peripheral artery disease, and CVD mortality with PTH actually were weakly inverse ( P trend = .02-.04) in the most fully adjusted models. For example, the hazard ratios across PTH quartiles were 1.00, 1.07, 1.07, and 0.96 ( P trend = .74) for coronary heart disease incidence and were 1.00, 0.69, 0.74, and 0.74 ( P trend = .02) for CVD mortality. Patterns were similar when restricted to participants with normal baseline kidney function. Conclusions This large prospective study failed to support the hypothesis that elevated PTH is an independent risk marker for incident CVD. When our data were added to the previous meta-analysis, the pooled hazard ratio remained statistically significant but weakened.</description><identifier>ISSN: 0002-8703</identifier><identifier>ISSN: 1097-6744</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2014.04.017</identifier><identifier>PMID: 25173540</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Body mass index ; Cardiac arrhythmia ; Cardiovascular ; Cardiovascular disease ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Classification ; Diabetes ; Drug therapy ; Female ; Glucose ; Heart failure ; Humans ; Incidence ; Laboratories ; Male ; Methods ; Middle Aged ; Mortality ; Older people ; Parathyroid Hormone - blood ; Prospective Studies ; Risk Assessment ; Smooth muscle ; Studies ; Vitamin D ; Vitamin deficiency</subject><ispartof>The American heart journal, 2014-09, Vol.168 (3), p.296-302</ispartof><rights>Mosby, Inc.</rights><rights>2014 Mosby, Inc.</rights><rights>Copyright © 2014 Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 2014</rights><rights>2014 Mosby, Inc. All rights reserved. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c670t-f42df87f23c5850a77d95adb8c98e8cd85e2fd5ea94b6a6ea85549ca434766603</citedby><cites>FETCH-LOGICAL-c670t-f42df87f23c5850a77d95adb8c98e8cd85e2fd5ea94b6a6ea85549ca434766603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25173540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Folsom, Aaron R., MD</creatorcontrib><creatorcontrib>Alonso, Alvaro, MD, PhD</creatorcontrib><creatorcontrib>Misialek, Jeffrey R., MPH</creatorcontrib><creatorcontrib>Michos, Erin D., MD</creatorcontrib><creatorcontrib>Selvin, Elizabeth, PhD</creatorcontrib><creatorcontrib>Eckfeldt, John H., MD, PhD</creatorcontrib><creatorcontrib>Coresh, Josef, MD, PhD</creatorcontrib><creatorcontrib>Pankow, James S., PhD</creatorcontrib><creatorcontrib>Lutsey, Pamela L., PhD</creatorcontrib><title>Parathyroid hormone concentration and risk of cardiovascular diseases: The Atherosclerosis Risk in Communities (ARIC) study</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding variables. Methods The ARIC study measured PTH using a second-generation assay (Roche, Indianapolis, IN) in stored serum samples from 1990 to 1992 and related levels in 10,392 adults to incident cardiovascular outcomes (coronary heart disease [n = 808], heart failure [n = 1,294], stroke [n = 586], peripheral artery disease [n = 873], atrial fibrillation [n = 1,190], and CVD mortality [n = 647]) through 2010 (median follow-up 19 years). Results Contrary to the hypothesis, PTH level was not associated positively with any CVD outcome. The associations of incident heart failure, peripheral artery disease, and CVD mortality with PTH actually were weakly inverse ( P trend = .02-.04) in the most fully adjusted models. For example, the hazard ratios across PTH quartiles were 1.00, 1.07, 1.07, and 0.96 ( P trend = .74) for coronary heart disease incidence and were 1.00, 0.69, 0.74, and 0.74 ( P trend = .02) for CVD mortality. Patterns were similar when restricted to participants with normal baseline kidney function. Conclusions This large prospective study failed to support the hypothesis that elevated PTH is an independent risk marker for incident CVD. 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We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding variables. Methods The ARIC study measured PTH using a second-generation assay (Roche, Indianapolis, IN) in stored serum samples from 1990 to 1992 and related levels in 10,392 adults to incident cardiovascular outcomes (coronary heart disease [n = 808], heart failure [n = 1,294], stroke [n = 586], peripheral artery disease [n = 873], atrial fibrillation [n = 1,190], and CVD mortality [n = 647]) through 2010 (median follow-up 19 years). Results Contrary to the hypothesis, PTH level was not associated positively with any CVD outcome. The associations of incident heart failure, peripheral artery disease, and CVD mortality with PTH actually were weakly inverse ( P trend = .02-.04) in the most fully adjusted models. For example, the hazard ratios across PTH quartiles were 1.00, 1.07, 1.07, and 0.96 ( P trend = .74) for coronary heart disease incidence and were 1.00, 0.69, 0.74, and 0.74 ( P trend = .02) for CVD mortality. Patterns were similar when restricted to participants with normal baseline kidney function. Conclusions This large prospective study failed to support the hypothesis that elevated PTH is an independent risk marker for incident CVD. When our data were added to the previous meta-analysis, the pooled hazard ratio remained statistically significant but weakened.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25173540</pmid><doi>10.1016/j.ahj.2014.04.017</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Body mass index
Cardiac arrhythmia
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - blood
Cardiovascular Diseases - epidemiology
Classification
Diabetes
Drug therapy
Female
Glucose
Heart failure
Humans
Incidence
Laboratories
Male
Methods
Middle Aged
Mortality
Older people
Parathyroid Hormone - blood
Prospective Studies
Risk Assessment
Smooth muscle
Studies
Vitamin D
Vitamin deficiency
title Parathyroid hormone concentration and risk of cardiovascular diseases: The Atherosclerosis Risk in Communities (ARIC) study
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