There was no difference in the number of smokers. elevated calcium concentrations compared with men with normal calcium concentrations, and was significantly higher than in the background populace (SMR 2.3, 95% CI 1.33.8). Cancer mortality was significantly increased in men (p = 0.039). Low calcium concentrations were also associated with higher mortality (p = 0.004), compared with patients with normal calcium concentrations. == Conclusion == This study underscores the importance of investigating patients with increased calcium concentrations suggesting that most of these patients 88% in our study will turn out to have an underlying disease associated with hypercalcaemia during a 10-12 months follow-up period. Elevated calcium concentrations had a different disease pattern in men and women, with men showing increased malignancy mortality in this study. Key Words:Gender, general practice, hypercalcaemia, mortality, longitudinal studies, primary care, primary hyperparathyroidism, Sweden A possible underlying TSU-68 (Orantinib, SU6668) cause of elevated calcium concentrations was found at baseline in 45% of 127 primary care patients. At the TSU-68 (Orantinib, SU6668) 10-12 months follow-up, there was an association with a condition potentially related to hypercalcaemia in 88% of the patients. Elevated calcium concentrations were mainly associated with primary hyperparathyroidism in female patients and with malignancies TSU-68 (Orantinib, SU6668) and increased mortality in male patients, compared with controls. It seems important to recheck elevated calcium concentrations as the levels may fluctuate. == Introduction == Several diseases can cause elevated calcium concentrations in serum and plasma, the most common being primary hyperparathyroidism (pHPT) and malignant diseases. The calcium concentration has been a routine laboratory analysis for decades and is used to screen for diseases, especially for pHPT, which is usually difficult to detect as the symptoms are often vague [1]. In the 1990s, some health care centres (HCCs) in Sweden were equipped with point-of-care assessments to analyse calcium, which was motivated by the authorities, but the number of assessments performed varied considerably between physicians [24]. Hospitalized patients often have more pronounced hypercalcaemia with aggravated symptoms, compared with patients in primary care; hence their diagnoses are often more obvious. In a previous study we showed that no underlying cause was found in 55% of the patients with elevated calcium concentrations in primary care [3]. As the calcium concentration is usually often included in primary care routine analyses, more knowledge is needed concerning the effects of increased calcium concentrations on morbidity and mortality. As very few studies have been performed on hypercalcaemia in primary care, there is a need for long-term studies of patients with elevated calcium concentrations [5]. The primary objective of this study was to investigate the long-term mortality and morbidity in patients with elevated calcium levels, analysed between 1995 and 2000, and in whom no immediate underlying diagnosis was found. The secondary objective was to study mortality in this cohort compared with normocalcaemic patients. == Material and methods == Tibro is usually a rural community with 11 000 inhabitants and one HCC. The medical records of all patients with elevated calcium concentrations TSU-68 (Orantinib, SU6668) between 1995 and 2000 have previously been studied [3]. Between 1993 and 2006, calcium was analysed in whole blood at the HCC laboratory in Tibro by Vision, Abbott. At baseline, 19952000, an elevated Rabbit polyclonal to LDLRAD3 calcium concentration was defined as at least one calcium test 2.56 mmol/l. Two age and sex-matched controls with calcium < 2.45 mmol/l were selected for each patient. Age was matched within two months, but for the TSU-68 (Orantinib, SU6668) oldest (n = 2), the match was within three years. Patients with calcium concentrations between 2.45 and 2.55 mmol/L were excluded from the control group. == Study subjects == A flow chart of study subjects is shown inFigure 1. Study subjects were invited by mail to participate in the follow-up to July 2011. nonresponders were contacted by telephone. Subjects who had moved were interviewed by phone and blood samples were taken at their local HCC. == Physique 1. == Flow chart of patients with elevated calcium concentrations at Tibro Health Care Centre, Sweden, 19952000, and re-examination of the patients with elevated and normal calcium concentrations during 20092010. Notes:Included in our previous study [3].Patients with hypercalcaemia at baseline not included in previous study because of technical problems.Two persons only answered the questionnaire, no laboratory samples. For patients with elevated calcium.