Letters |

Thiazide Use and Reduced Sodium Intake for Prevention of Osteoporosis—Reply

Anne Klibanski, MD
JAMA. 2001;285(18):2323-2324. doi:10.1001/jama.285.18.2323.
Text Size: A A A
Published online


In Reply: Dr Bobrow and Dr Cappuccio highlight the important relationship between sodium and calcium balance with respect to bone density. Thiazide diuretics lower urinary calcium excretion, and several studies have reported increased bone density and decreased fracture risk in patients treated with thiazides. The 1983 cross-sectional study by Wasnich et al1 found a positive effect of thiazide use on bone density. A protective effect on hip fracture in older men and women receiving thiazides has also been shown. However, the recommended use of thiazides in normotensive individuals to prevent fractures warrants separate consideration. The most compelling data in this regard were not published until after the March 2000 Consensus Conference.2 A protective effect of low-dose thiazides on bone mineral density in this study was observed in normotensive women and men aged 60 years or older. This is the only such large randomized, placebo-controlled trial. However, specific recommendations as to the clinical role of thiazides in osteoporosis prevention remain to be determined.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.