Hypercalcemia and primary hyperparathyroidism. Prevalence in patients receiving thiazides as detected in a health screen

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Abstract
Patients (20) being treated with thiazides were found among 95 subjects (21%) with hypercalcemia verified in repeated determinations in a health screening of 15,903 persons. There were 1034 patients treated with thiazides in this total health screening. Prevalence of hypercalcemia in patients treated with thiazide (1.9%) was considerably higher than prevalence of hypercalcemia found in the entire healthscreened population (0.6%). Thiazide treatment was withdrawn in 20 hypercalcemic subjects after examination, and the patients were observed at intervals during a follow-up period of 1 yr. Necks of 14 were explored during or after the follow-up period because of an initial serum Ca level .gtoreq. 3.0 mmol/l or persistent hypercalcemia. Parathyroid adenomas were seen in all patients receiving surgery. Single adenomas predominated in surgical findings. The finding of the present high number of patients with primary hyperparathyroidism may be associated with elevated blood pressure resulting in thiazide treatment after detection.