To the Editor Graff-Baker et al¹ are to be congratulated for their investigation regarding whether parathyroidectomy reverses hypertension in patients with primary hyperparathyroidism (PHPT) compared with nonsurgical patients by assessing changes in mean arterial pressure (MAP) and antihypertensive medication use in their retrospective cohort study. Hypercalcemia and elevated parathyroid hormone levels characterize PHPT, which affects approximately 1% of the population.² Conflicting evidence exists regarding exact mechanisms of cardiovascular involvement,² notably hypertension, making it difficult to draw clinically meaningful conclusions. This study¹ analyzed 2380 patients for 2 years and reported that surgical patients had lower antihypertensive medication requirements and decreases in MAP. This letter explores improvements to study design and alternative conclusions to increase clinical impact.

给编辑的格拉夫-Baker等人¹被以关于应祝贺他们的调查是否甲状旁腺切除逆转高血压患者与非手术患者通过评估的平均动脉压（MAP）的变化，并在其回顾性抗高血压药物的使用相比，原发性甲状旁腺功能亢进（PHPT）队列研究。高钙血症和甲状旁腺激素水平升高是PHPT的特征，它影响了大约1％的人口。²关于心血管受累的确切机制存在矛盾的证据，²尤其是高血压，因此很难得出具有临床意义的结论。本研究¹对2380位患者进行了2年的分析，并报告手术患者降低了降压药物的需求，降低了MAP。这封信探讨了研究设计的改进和其他结论，以增加临床影响。