(1) VU University, Amsterdam, the Netherlands
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Introduction
Cardiovascular diseases (CVD) have become one of the major causes of death. Over the past decade, vitamin D has attracted substantial interest towards extra-skeletal role in various disease condition, including CVD. Circulating PTH is a major regulator of bone and mineral metabolism and stimulates the conversion of vitamin D to its most active form. Several studies suggested parathyroid hormone (PTH) not only as a biomarker of vitamin D status but also as an independent cardiovascular risk factor that contributes to the progression of CVD.
The objective of this review is to describe the role of disturbances in PTH in relation to CVD.
Discussion
Growing evidence suggests a link between higher PTH concentrations and CVD. Few studies indicate that PTH excess may influence underlying mechanism of CVD including cardiac biomarkers, cardiac structure and incident hypertension, which in turn may promote cardiovascular disease risk. Based on the total evidence in the field, the beneficial effect of vitamin D supplementation by suppressing PTH on cardiovascular health in the general population still needs to be established. Nonetheless, higher PTH concentrations may be involved in cardiac metabolism and repair, and could play a role in the prevention of cardiac diseases.
Conclusion
Excess PTH is a common finding among older populations. As higher PTH concentrations may be harmful for cardiovascular health, suppression of PTH – either by vitamin D therapy or more specific PTH suppression – might help to prevent cardiac disease and lower CVD rates. Based on the current evidence,
there is no reason to change the current recommendation to improve vitamin D status (and subsequently lower PTH status) of the general population with regard to influencing cardiovascular
risk.
