Increased mortality and morbidity in mild primary hyperparathyroid patients. The Parathyroid Epidemiology and Audit Research Study (PEARS)

OBJECTIVE: To describe mortality and disease-specific morbidities in patients with mild primary hyperparathyroidism (PHPT). DESIGN: Retrospective population-based observational study. SETTING: Tayside, Scotland, from 1997 to 2006. PARTICIPANTS: Patients with mild PHPT were selected from a predefined PHPT cohort between 1997 and 2006. MAIN OUTCOME MEASURES: Standardised mortality ratios (SMRs) were examined for all-cause mortality, as well as cardiovascular and cancer mortality. Standardised morbidity ratios and standardised incidence ratios were also calculated for eleven observed co-morbidities. RESULTS: In total, there were 1683 (69.1% female) patients identified with mild PHPT in Tayside. Patients were found to have an increased risk of all-cause mortality and cardiovascular mortality (SMR-all cause 2.62, 95% CI 2.39-2.86; SMR-cardiovascular 2.68, 95% CI 2.34-3.05). Patients with mild PHPT had a significantly increased risk of developing cardiovascular and cerebrovascular disease, renal dysfunction and fractures compared to the age- and sex-adjusted general population. CONCLUSIONS: Mortality and morbidity were increased for patients with mild untreated PHPT, which is similar to more severe PHPT.