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Comment & Response |

Blood Pressure and Serum Parathyroid Hormone Level

Jaime García de Tena, MD, PhD1; Cristina Hernández-Gutiérrez, MD1; Laura Abejón-López, MD2
[+] Author Affiliations
1Department of Internal Medicine, Hospital Universitario de Guadalajara, Universidad de Alcalá, Spain
2Emergency Medicine Department, Hospital Infanta Sofía, San Sebastián de los Reyes, Spain
JAMA Intern Med. 2015;175(6):1069. doi:10.1001/jamainternmed.2015.0760.
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To the Editor In their Research Letter testing the hypothesis of an association between diuretic use and elevated serum parathyroid hormone (PTH) levels in adults with normal renal function, Corapi et al1 state that their findings demonstrate that loop use is associated with higher PTH level, even after adjustment for potential confounders. Of note, the authors did not include blood pressure as a covariate in their multivariable model. Although heart failure—included in the multivariable analysis—is one of its main indications, loop diuretics are not exclusively used for this condition and have been shown to achieve a good response as combination therapy in patients with resistant hypertension.2 Moreover, a history of hypertension is common in patients with heart failure, especially in those with preserved left ventricular systolic function.2

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June 1, 2015
Kristin M. Corapi, MD, MMSc; Julia B. Wenger, MPH; Ishir Bhan, MD, MPH
1Division of Nephrology, Massachusetts General Hospital, Boston
JAMA Intern Med. 2015;175(6):1069-1070. doi:10.1001/jamainternmed.2015.0763.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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