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July 23/30, 2003

Blood Lead Levels and Hypertension—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(4):461-462. doi:10.1001/jama.290.4.461-a

In Reply: In our article we performed the regression analysis based on our a priori hypothesis concerning the potential impact of soluble Fas ligand on renal function, and hence we examined the relationship between changes in plasma levels of soluble Fas ligand and changes in plasma levels of creatinine in all patients. Regression analysis of the 2 ventilatory groups separately, as suggested by Mr Kuo, results in a significant positive correlation for the control group and a nonsignificant negative correlation for the lung protective strategy. The apparent negative correlation for the lung protective group is due to 1 data point. In any event, even if there were 2 separate relationships, this would not affect the biological message that an injurious ventilatory strategy may lead to an increase in levels of soluble Fas ligand, which may be associated with worsening of plasma levels of creatinine.