UNCHANGED NORADRENALINE REACTIVITY AND BLOOD-PRESSURE AFTER CORRECTIVE SURGERY IN PRIMARY HYPERPARATHYROIDISM

In order to evaluate the role of the hyperparathyroid state for blood pressure and volume homeostasis, eight patients with primary hyperpara thyroidism were studied before and after corrective surgery. Neither n oradrenaline induced blood pressure changes nor basal blood pressure w ere affected by the operation, and the values were the same as in an a ge- and sex-matched control group. Noradrenaline infusion induced an i ncrease in PTH(1-84) values before (72-86 ng l-1, medians, p < 0.02), in contrast to a decrease after (28 to 19 ng l-1, p < 0.05) operation for primary hyperparathyroidism. Basal plasma atrial natriuretic pepti de was lower before than after removal of adenomata (3.2 vs. 4.8 pmol l-1, medians, p < 0.02). Cyclic 3'-5'-guanosine monophosphate was not significantly changed (4.7 vs. 5.5 nmol l-1). Aldosterone was higher b efore than after surgery (I 39 vs. 71 pmol l-1, p < 0.02), whereas ang iotensin II was unaltered (20 vs. 9 pmol l-1). Arginine vasopressin wa s higher before than after the operation (0.9 vs. 0.7 pmol l-1, p < 0. 05), but urinary excretion of prostaglandin E2 was unchanged. In concl usion primary hyperparathyroidism was not associated with changes in n oradrenaline reactivity or basal blood pressure despite derangements o f hormones adjusting sodium and water homeostasis. It is suggested tha t the hormonal changes may be secondary to a relative volume depletion .