Elsevier

American Heart Journal

Volume 160, Issue 4, October 2010, Pages 715-720
American Heart Journal

Clinical Investigation
Hypertension
Lack of association between serum magnesium and the risks of hypertension and cardiovascular disease

https://doi.org/10.1016/j.ahj.2010.06.036Get rights and content

Background

Experimental studies have linked hypomagnesemia with the development of vascular dysfunction, hypertension, and atherosclerosis. Prior clinical studies have yielded conflicting results but were limited by the use of self-reported magnesium intake or short follow-up periods.

Methods

We examined the relationship between serum magnesium concentration and incident hypertension, cardiovascular disease (CVD), and mortality in 3,531 middle-aged adult participants in the Framingham Heart Study offspring cohort. Analyses were performed using Cox proportional hazards regressions, adjusted for traditional CVD risk factors.

Results

Follow-up was 8 years for new-onset hypertension (551 events) and 20 years for CVD (554 events). There was no association between baseline serum magnesium and the development of hypertension (multivariable-adjusted hazards ratio per 0.15 mg/dL 1.03, 95% CI 0.92-1.15, P = .61), CVD (0.83, 95% CI 0.49-1.40, P = .49), or all-cause mortality (0.77, 95% CI 0.41-1.45, P = .42). Similar findings were observed in categorical analyses, in which serum magnesium was modeled in categories (<1.5, 1.5-2.2, >2.2 mg/dL) or in quartiles.

Conclusions

In conclusion, data from this large, community-based cohort do not support the hypothesis that low serum magnesium is a risk factor for developing hypertension or CVD.

Section snippets

Study sample

The Framingham Heart Study began recruitment of an offspring cohort in 1971 with the enrollment of 5,124 children of the original Framingham Heart Study participants. Study design and selection criteria for this study have been previously described.39 Participants attending the second examination of the offspring cohort (n = 3,863), which took place between 1979 and 1982, were eligible for the current investigation. We excluded participants lacking a serum magnesium measurement (n = 176) or

Characteristics of the study sample

Baseline characteristics are shown in Table I for the samples used in the incident hypertension analyses (n = 2,520) and the incident CVD and mortality analyses (n = 3,531). There were 772 (22%) participants with prevalent hypertension at the baseline examination. The range of observed values for magnesium was 1.41 to 2.40 mg/dL in men and 1.15 to 2.46 mg/dL in women. The number of participants with serum magnesium <1.5 mg/dL was 12 for the hypertension analyses and 24 for the CVD and death

Discussion

We found no association between serum magnesium levels and the subsequent development of hypertension, CVD, or all-cause mortality. The validity of these findings is supported by the use of a large, well-characterized epidemiologic cohort, routine adjudication for incident hypertension and CVD, a large number of events, and standardized assessment of serum magnesium.

Our findings are in contrast to those of prior studies that have related magnesium status to cardiovascular outcomes.22, 23, 24, 25

References (50)

  • PeacockJ.M. et al.

    Relationship of serum and dietary magnesium to incident hypertension: the Atherosclerosis Risk in Communities (ARIC) Study

    Ann Epidemiol

    (1999)
  • KochS.M. et al.

    The simultaneous measurement of ionized and total calcium and ionized and total magnesium in intensive care unit patients

    J Crit Care

    (2002)
  • ShechterM. et al.

    Effects of oral magnesium therapy on exercise tolerance, exercise-induced chest pain, and quality of life in patients with coronary artery disease

    Am J Cardiol

    (2003)
  • YamamotoM.E. et al.

    Lack of blood pressure effect with calcium and magnesium supplementation in adults with high-normal blood pressure. Results from Phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOHP) Collaborative Research Group

    Ann Epidemiol

    (1995)
  • WittemanJ.C. et al.

    Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension

    Am J Clin Nutr

    (1994)
  • TouitouY. et al.

    Prevalence of magnesium and potassium deficiencies in the elderly

    Clin Chem

    (1987)
  • AlturaB.M. et al.

    Magnesium deficiency and hypertension: correlation between magnesium-deficient diets and microcirculatory changes in situ

    Science

    (1984)
  • BernardiniD. et al.

    Magnesium and microvascular endothelial cells: a role in inflammation and angiogenesis

    Front Biosci

    (2005)
  • ShechterM. et al.

    Oral magnesium therapy improves endothelial function in patients with coronary artery disease

    Circulation

    (2000)
  • WeglickiW.B. et al.

    Magnesium-deficiency elevates circulating levels of inflammatory cytokines and endothelin

    Mol Cell Biochem

    (1992)
  • FungT.T. et al.

    The association between magnesium intake and fasting insulin concentration in healthy middle-aged women

    J Am Coll Nutr

    (2003)
  • HuertaM.G. et al.

    Magnesium deficiency is associated with insulin resistance in obese children

    Diabetes Care

    (2005)
  • NadlerJ.L. et al.

    Magnesium deficiency produces insulin resistance and increased thromboxane synthesis

    Hypertension

    (1993)
  • KaoW.H. et al.

    Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the Atherosclerosis Risk in Communities Study

    Arch Intern Med

    (1999)
  • Guerrero-RomeroF. et al.

    Low serum magnesium levels and metabolic syndrome

    Acta Diabetol

    (2002)
  • Cited by (71)

    • Drinking water magnesium and cardiovascular mortality: A cohort study in Denmark, 2005–2016

      2022, Environment International
      Citation Excerpt :

      Trends towards lower risk of IHD and fatal IHD was also observed. However, others have not found an association between either dietary magnesium in women and incident CV disease (Song et al., 2005) or serum magnesium and CV disease (Khan et al., 2010). It is suggested that the mechanisms linking a low concentration of magnesium with CV diseases is different between serum magnesium and dietary magnesium, which may explain the different finding between studies of serum magnesium and dietary magnesium and risk of CV diseases (Ohira et al., 2009).

    • Environmental heavy metals and cardiovascular diseases: Status and future direction

      2020, Chronic Diseases and Translational Medicine
      Citation Excerpt :

      Although the evidence has been updated in recent reviews, it is far from establishing causality. A major limitation of these studies is their cross-sectional in design, except for As, Cd, Pb, Mg, and Se, for which increasing prospective evidence generally consistently shows an increased risk (As, Cd, and Pb) of CVD risk (decreased risk from Mg22,24,31–65 and Se61,70–84). Exposures to Ni and Mn have been associated with the risk of hypertension and CVD mortality.97–101

    View all citing articles on Scopus
    View full text