Hypertension Rounds: Successful Treatment With Evocalcet For Resistant Hypertension Induced by Asymptomatic Primary Hyperparathyroidism

Abstract Primary hyperparathyroidism (PHPT) is a known cause of secondary hypertension; however, the extent to which blood pressure improves following treatment remains controversial. Moreover, reports on the use of calcimimetics for managing hypertension in patients with PHPT are scarce. Here, we report the case of a woman in her 50s with refractory hypertension associated with PHPT and mild hypercalcemia. She had no evidence of parathyroid enlargement, renal impairment, or history of nephrolithiasis. Bone mineral density was reduced at both the femoral neck and lumbar spine. Treatment with evocalcet led to an improvement in her previously resistant hypertension, allowing for the dose reduction or discontinuation of conventional antihypertensive agents. This case highlights the importance of considering PHPT as a potential underlying etiology in patients presenting with hypertension and episodic hypercalcemia.