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International Journal of Endocrinology
Volume 2017, Article ID 4138783, 8 pages
https://doi.org/10.1155/2017/4138783
Clinical Study

Angiotensin-Converting Enzyme Inhibition and Parathyroid Hormone Secretion

1Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
2Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Correspondence should be addressed to Sarah Zaheer; ude.dravrah.hwb@reehazs and Anand Vaidya; ude.dravrah.hwb@aydiavdnana

Received 19 April 2017; Accepted 31 May 2017; Published 20 July 2017

Academic Editor: Nicolas Verheyen

Copyright © 2017 Sarah Zaheer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion. Objective. To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in participants with and without primary hyperparathyroidism (P-HPT). Methods. An open-label, single-arm, pilot study whereby participants with and without P-HPT had PTH were evaluated before and after 1 week of maximally tolerated lisinopril therapy. Results. A total of 12 participants with, and 15 participants without, P-HPT successfully completed the protocol. Following 1 week of lisinopril, participants with P-HPT had a decrease in systolic blood pressure (SBP) (−6.4 mmHg, ), an increase in plasma renin activity (PRA) (+1.50 ng/mL/h, ), and a decrease in PTH (79.5 (21.6) to 70.9 (19.6) pg/mL,  pg/mL, ); however, serum and urine calcium did not change. In contrast, although 1 week of lisinopril significantly decreased SBP and increased PRA among participants without P-HPT, there were no changes in PTH or calcium. Conclusion. In this short pilot investigation, 1 week of maximally titrated ACEi did not impact PTH in participants without P-HPT, but resulted in a modest and marginally significant reduction of PTH but not calcium, among participants with P-HPT. This trial is registered with ClinicalTrials.gov NCT01691781.