高血压与甲状旁腺激素(PTH)水平较高有关，特定的降压药可能调节PTH。美国学者对高血压病史和使用特定降压药是否决定原发性甲状旁腺机能亢进症(P-HPTH)发生风险进行了一项大型前瞻性研究，结果表明，在大多数白种女性人群中，高血压病史和使用利尿剂呋塞米(俗称速尿)与P-HPTH发生风险显著较高有关。相关论文4月17日在线发表于《临床内分泌代谢杂志》(J Clin Endocrinol Metab)。

        该纵向前瞻性队列研究纳入了NHS研究中的女性护理人员，随访时间为1986至2008年，受试者基线均无P-HPTH，通过调查问卷评估P-HPTH病史，最终完成例数为75600。大多数受试者为白种人且是绝经后女性。主要中国终点为通过调查问卷最初评估的P-HPTH发生率，然后通过医疗记录审查对其确认。利用Cox比例风险模型校正潜在混杂因素。

        结果显示，在1719416人-年随访期间，共报告有347例发生P-HPTH。与高血压有关的、校正年龄后的P-HPTH相对风险为1.80，多变量校正后的相对风险为1.45。

        在有高血压病史的受试者中，与使用其他降压药相比，使用呋塞米与P-HPTH发生风险增加有关，校正年龄后和多变量后，P-HPTH相对风险分别为1.79和1.71。

        参考文献：

        Anand Vaidya,et al. J Clin Endocrinol Metab.2015 Apr 17:jc20151619. [Epub ahead of print]. DOI: http://dx.doi.org/10.1210/jc.2015-1619

Hypertension, Anti-Hypertensive Medications, and Risk of Incident Primary Hyperparathyroidism
Anand VaidyaMD MMSc1,4,6, Gary C. CurhanMD ScD2,3,4,6, Julie M. PaikMD, MPH2,3,4,6, Henry KronenbergMD5,6, and Eric N. TaylorMD, MSc3,4,7

Abstract
Context:
Hypertension associates with higher parathyroid hormone (PTH) levels, and specific anti-hypertensive medications may modulate PTH. Whether hypertension, or the use of specific anti-hypertensive medications, influences the risk of developing incident primary hyperparathyroidism (P-HPTH) is not known.
Objective:
To investigate whether history of hypertension and the use of specific anti-hypertensive medications determine the risk for developing P-HPTH in a large prospective study.
Design/Participants:
Longitudinal prospective cohort study of female nurses in the Nurses' Health Study I (NHS) followed from 1986 to 2008 who did not have P-HPTH at baseline and completed questionnaire assessment of lifetime history of P-HPTH (n=75,600). Most participants were white and post-menopausal.
Setting:
Nurses in a nationwide cohort study.
Main Outcome Measure:
Incident P-HPTH assessed initially via questionnaire and then confirmed by medical record review. Cox proportional hazards models were used to adjust for potential confounders.
Results:
We documented 347 incident cases of P-HPTH during 1,719,416 person-years of follow-up. The age-adjusted relative risk for incident P-HPTH associated with hypertension was 1.80 (95% CI: 1.43, 2.26) and multivariate adjusted relative risk was 1.45 (1.10, 1.91). Among participants with a history of hypertension, the use of furosemide, when compared with the use of other anti-hypertensive medications, was associated with increased risk for developing P-HPTH; age-adjusted relative risk for incident P-HPTH was 1.79 (1.15, 2.79) and multivariate adjusted relative risk was 1.71 (1.08, 2.71).
Conclusions:
In a large longitudinal prospective cohort study of mostly older white women, a history of hypertension and use of furosemide were associated with a significantly higher risk of developing P-HPTH.