LONG-TERM HEALTH RISK OF PRIMARY HYPERPARATHYROIDISM - THE EFFECT OF SURGERY

Primary hyperparathyroidism is a common disease but 90% of sufferers r emain undetected. In elderly women its prevalence is about 1%, The dis ease can cause severe hypercalcaemia and lead to life-threatening symp toms, However, the majority of cases represent milder forms of hyperpa rathyroidism with minimal symptoms or no symptoms at all, and slight h ypercalcaemia which does not progress during follow-up, Surgery is the only effective treatment of primary hyperparathyroidism and most of t he symptoms respond favourably to surgery, Nevertheless, the role of s urgery has been controversial in the treatment of minisymptomatic pati ents, Recently it has become evident that primary hyperparathyroidism is associated with increased mortality due mainly to cardiovascular di seases, and it has been shown that surgical treatment is able to dimin ish or even eliminate this risk of premature death, The extra mortalit y is connected also to the mild and nonprogressive forms of the diseas e, and it seems to have a strong correlation with the duration of the disease, This aspect favours active treatment at an early stage of the disease, Conservative treatment can be considered only in old patient s with mild and stable clinical course, Primary hyperparathyroidism is an important risk factor causing morbidity and mortality.