An elevated serum PTH might cause complications at the clinical and subclinical level, even in patients with normal serum calcemic values, with anomalies including endothelial anomalies, vascular rigidity, high blood pressure, coronary disease, atherosclerosis, etc. In NPHPT, the exact level of calcium-PTH impact and the exact extent of their post-operatory improvement are still open issues, but long-term surveillance is mandatory in patients who are conservatively approached. The gene discussed is PTH; the disease is atherosclerosis.