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Sun C, Li J, Zhao Z, Ren S, Guan Y, Zhang M, Li T, Tan L, Yao Q, Chen L. The correlation between fruit intake and all-cause mortality in hypertensive patients: a 10-year follow-up study. Front Nutr 2024; 11:1363574. [PMID: 38585613 PMCID: PMC10995410 DOI: 10.3389/fnut.2024.1363574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Objective Extensive research has consistently shown the beneficial impact of fruit consumption on overall health. While some studies have proposed a potential association between fruit consumption and hypertension management, the influence of fruit consumption on mortality rates among hypertensive individuals remains uncertain. Consequently, aim of this study is to evaluate whether fruit consumption is associated with all-cause mortality among hypertensive patients. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES), conducted between 2003 and 2006. Ten-year follow-up data from the National Death Index (NDI) were used to assess all-cause mortality. Cox proportional hazard model was utilized to explore the impact of fruit intake on all-cause mortality among hypertensive individuals. Results The study included a cohort of 2,480 patients diagnosed with hypertension, and during the follow-up period, a total of 658 deaths from various causes were recorded. The COX regression analysis demonstrated that hypertensive patients who consumed apples three to six times per week exhibited a significantly reduced risk of all-cause mortality (HR = 0.60, 95%CI: 0.45-0.78, p < 0.001) in comparison to those who consumed apples less than once per month. Likewise, consuming bananas three to six times per week also led to a comparable outcome (HR = 0.76, 95%CI: 0.59-0.97, p = 0.027). Moreover, Combined consumption of bananas and apples three to six times per week exhibited a noteworthy decrease in all-cause mortality (HR = 0.57, 95%CI: 0.39-0.84, p = 0.005) when compared to individuals who consumed these fruits less frequently. Conversely, no significant association was found between the consumption of other fruits, including pears, pineapples, and grapes, and all-cause mortality. Conclusion The study discovered that moderate consumption of apples and bananas was associated with a reduced risk of all-cause mortality in patients with hypertension.
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Affiliation(s)
- Chuang Sun
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jie Li
- General Practice Department, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Zeyuan Zhao
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shupeng Ren
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yue Guan
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Miaoan Zhang
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tianfeng Li
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Linglin Tan
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qiying Yao
- Department of Physiology, Dalian Medical University, Dalian, China
| | - Liang Chen
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Sun P, Wang Z, Li B, Chen S. Association of Dietary Magnesium Intake with the Risk of Stroke among Adults. Int Heart J 2023; 64:1002-1009. [PMID: 37967982 DOI: 10.1536/ihj.23-299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
The relationship between dietary magnesium intake and the risk of stroke is controversial. This study aimed to examine the association of dietary magnesium intake with the risk of stroke among American adults.The relationship between dietary magnesium intake and the risk of stroke was analyzed using the National Health and Nutrition Examination Survey (NHANES) 2007-2018 data with 29,653 adults. The amount of magnesium from the diet was assessed by two 24-hour dietary recalls. Stroke outcomes were defined using the results of the self-reported questionnaires. The association between dietary magnesium intake and the risk of stroke was evaluated using logistic regression models and restricted cubic spline.In our study, an inverse association between dietary magnesium intake and the risk of stroke was found. For the highest versus lowest quartile of dietary magnesium intake, the multivariate-adjusted odds ratio (95% confidence interval) of stroke was 0.56 (0.36-0.86). The magnesium intake of women was negatively associated with stroke risk, but this negative association was not found in men. Then, the inverse association was statistically significant among the 40-59 year-old group. The results from the dose-response analysis show a linear relationship between dietary magnesium intake and the risk of stroke.Dietary magnesium intake was inversely associated with the risk of stroke, especially in women. Therefore, our study emphasizes the importance of appropriately increasing dietary magnesium intake.
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Affiliation(s)
- Peng Sun
- Department of Cardiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University
| | - Zhiqiang Wang
- Department of Outpatient, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University
| | - Bo Li
- Department of General Practice, Zhangcun Town Health Center in Huancui District
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The Effect of Magnesium Supplementation on Endothelial Function: A Randomised Cross-Over Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158169. [PMID: 34360460 PMCID: PMC8346147 DOI: 10.3390/ijerph18158169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Evidence supports an association between low magnesium (Mg) intake and coronary heart disease and between Mg intake and endothelial function. The aim of this study was to assess the effect of one week of Mg supplementation on endothelial function, assessed by flow mediated dilatation (FMD). Nineteen healthy men and women completed this cross-over pilot study in which participants were randomised to take an over-the-counter magnesium supplement for one week or to follow their usual diet. Weight, FMD and blood pressure (BP) were taken on completion of each intervention and 24 h urine collections and blood samples were taken to assess compliance. Baseline serum Mg was within normal range for all participants. Urinary Mg and urinary magnesium-creatinine ratio (Mg/Cr) significantly increased between interventions, (p = 0.03, p = 0.005, respectively). No significant differences in FMD or BP were found between the interventions. A significant negative correlation was seen between age and FMD (r = −0.496, p = 0.031). When adjusted for age, saturated fat was negatively associated with FMD (p = 0.045). One week of Mg supplementation did not improve FMD in a healthy population.
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Fiorentini D, Cappadone C, Farruggia G, Prata C. Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients 2021; 13:1136. [PMID: 33808247 PMCID: PMC8065437 DOI: 10.3390/nu13041136] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/11/2022] Open
Abstract
Magnesium plays an important role in many physiological functions. Habitually low intakes of magnesium and in general the deficiency of this micronutrient induce changes in biochemical pathways that can increase the risk of illness and, in particular, chronic degenerative diseases. The assessment of magnesium status is consequently of great importance, however, its evaluation is difficult. The measurement of serum magnesium concentration is the most commonly used and readily available method for assessing magnesium status, even if serum levels have no reliable correlation with total body magnesium levels or concentrations in specific tissues. Therefore, this review offers an overview of recent insights into magnesium from multiple perspectives. Starting from a biochemical point of view, it aims at highlighting the risk due to insufficient uptake (frequently due to the low content of magnesium in the modern western diet), at suggesting strategies to reach the recommended dietary reference values, and at focusing on the importance of detecting physiological or pathological levels of magnesium in various body districts, in order to counteract the social impact of diseases linked to magnesium deficiency.
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Affiliation(s)
| | | | - Giovanna Farruggia
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.F.); (C.C.); (C.P.)
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5
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Asbaghi O, Hosseini R, Boozari B, Ghaedi E, Kashkooli S, Moradi S. The Effects of Magnesium Supplementation on Blood Pressure and Obesity Measure Among Type 2 Diabetes Patient: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Trace Elem Res 2021; 199:413-424. [PMID: 32385715 DOI: 10.1007/s12011-020-02157-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
In this study, we aimed to systematically review the literature to evaluate the effects of magnesium (Mg) supplementation on blood pressure (BP) and obesity measure among patients with type 2 diabetes mellitus (T2DM). Major electronic databases of Web of Science, the Cochrane library, PubMed, and Scopus were searched completely from the inception until 15 October 2019 to identify randomized clinical trials (RCTs) pertaining to the topic of interest. All outcomes were pooled using a random-effects model and expressed as weighted mean differences (WMD) with 95% confidential intervals (CI). Heterogeneity, sensitivity analysis, and publication bias were also assessed using standard methods. The pooled analysis of five RCTs showed that Mg supplementation did not affect body weight (WMD: - 0.01 kg, 95% CI: - 0.36 to 0.33), BMI (WMD: - 0.07, 95% CI: - 0.18 to 0.04), and waist circumference (WMD: 0.12, 95% CI: - 1.24 to 1.48) in T2DM patients compared to the control groups of the patients who received placebo. However, pooling seven RCTs together showed significant reduction of systolic blood pressure (WMD: - 5.78 mmHg, 95% CI: - 11.37 to - 0.19) and diastolic blood pressure (WMD: - 2.50 mmHg, 95% CI: - 4.58 to - 0.41) in T2DM patients. Furthermore, subgroup analysis by dose of intervention, intervention duration, and type of intervention suggested that Mg supplementation for > 12 weeks, in doses higher than 300 mg/day or inorganic forms, could significantly decrease both systolic and diastolic BP in T2DM patients. Based on the findings, Mg supplementation has beneficial effects on BP in type 2 diabetes patients independent of body weight status. However, further investigations are needed to provide more reliable evidences.
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Affiliation(s)
- Omid Asbaghi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Reza Hosseini
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnoosh Boozari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Kashkooli
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sajjad Moradi
- Halal Research Centre of IRI, FDA, Tehran, Iran.
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Magnesium in Aging, Health and Diseases. Nutrients 2021; 13:nu13020463. [PMID: 33573164 PMCID: PMC7912123 DOI: 10.3390/nu13020463] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 12/15/2022] Open
Abstract
Several changes of magnesium (Mg) metabolism have been reported with aging, including diminished Mg intake, impaired intestinal Mg absorption and renal Mg wasting. Mild Mg deficits are generally asymptomatic and clinical signs are usually non-specific or absent. Asthenia, sleep disorders, hyperemotionality, and cognitive disorders are common in the elderly with mild Mg deficit, and may be often confused with age-related symptoms. Chronic Mg deficits increase the production of free radicals which have been implicated in the development of several chronic age-related disorders. Numerous human diseases have been associated with Mg deficits, including cardiovascular diseases, hypertension and stroke, cardio-metabolic syndrome and type 2 diabetes mellitus, airways constrictive syndromes and asthma, depression, stress-related conditions and psychiatric disorders, Alzheimer's disease (AD) and other dementia syndromes, muscular diseases (muscle pain, chronic fatigue, and fibromyalgia), bone fragility, and cancer. Dietary Mg and/or Mg consumed in drinking water (generally more bioavailable than Mg contained in food) or in alternative Mg supplements should be taken into consideration in the correction of Mg deficits. Maintaining an optimal Mg balance all through life may help in the prevention of oxidative stress and chronic conditions associated with aging. This needs to be demonstrated by future studies.
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7
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Rosanoff A, Costello RB, Johnson GH. Effectively Prescribing Oral Magnesium Therapy for Hypertension: A Categorized Systematic Review of 49 Clinical Trials. Nutrients 2021; 13:E195. [PMID: 33435187 PMCID: PMC7827637 DOI: 10.3390/nu13010195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 12/17/2022] Open
Abstract
Trials and meta-analyses of oral magnesium for hypertension show promising but conflicting results. An inclusive collection of 49 oral magnesium for blood pressure (BP) trials were categorized into four groups: (1) Untreated Hypertensives; (2) Uncontrolled Hypertensives; (3) Controlled Hypertensives; (4) Normotensive subjects. Each group was tabulated by ascending magnesium dose. Studies reporting statistically significant (p < 0.05) decreases in both systolic BP (SBP) and diastolic BP (DBP) from both baseline and placebo (if reported) were labeled "Decrease"; all others were deemed "No Change." Results: Studies of Untreated Hypertensives (20 studies) showed BP "Decrease" only when Mg dose was >600 mg/day; <50% of the studies at 120-486 mg Mg/day showed SBP or DBP decreases but not both while others at this Mg dosage showed no change in either BP measure. In contrast, all magnesium doses (240-607 mg/day) showed "Decrease" in 10 studies on Uncontrolled Hypertensives. Controlled Hypertensives, Normotensives and "magnesium-replete" studies showed "No Change" even at high magnesium doses (>600 mg/day). Where magnesium did not lower BP, other cardiovascular risk factors showed improvement. Conclusion: Controlled Hypertensives and Normotensives do not show a BP-lowering effect with oral Mg therapy, but oral magnesium (≥240 mg/day) safely lowers BP in Uncontrolled Hypertensive patients taking antihypertensive medications, while >600 mg/day magnesium is required to safely lower BP in Untreated Hypertensives; <600 mg/day for non-medicated hypertensives may not lower both SBP and DBP but may safely achieve other risk factor improvements without antihypertensive medication side effects.
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Affiliation(s)
- Andrea Rosanoff
- CMER Center for Magnesium Education &Research, Pahoa, HI 96778, USA;
| | | | - Guy H. Johnson
- Johnson Nutrition Solutions LLC, Minneapolis, MN 55416, USA;
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8
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Magnesium and Hypertension in Old Age. Nutrients 2020; 13:nu13010139. [PMID: 33396570 PMCID: PMC7823889 DOI: 10.3390/nu13010139] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/27/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022] Open
Abstract
Hypertension is a complex condition in which various actors and mechanisms combine, resulting in cardiovascular and cerebrovascular complications that today represent the most frequent causes of mortality, morbidity, disability, and health expenses worldwide. In the last decades, there has been an exceptional amount of experimental, epidemiological, and clinical studies confirming a close relationship between magnesium deficit and high blood pressure. Multiple mechanisms may help to explain the bulk of evidence supporting a protective effect of magnesium against hypertension and its complications. Hypertension increases sharply with advancing age, hence older persons are those most affected by its negative consequences. They are also more frequently at risk of magnesium deficiency by multiple mechanisms, which may, at least in part, explain the higher frequency of hypertension and its long-term complications. The evidence for a favorable effect of magnesium on hypertension risk emphasizes the importance of broadly encouraging the intake of foods such as vegetables, nuts, whole cereals and legumes, optimal dietary sources of magnesium, avoiding processed food, which are very poor in magnesium and other fundamental nutrients, in order to prevent hypertension. In some cases, when diet is not enough to maintain an adequate magnesium status, magnesium supplementation may be of benefit and has been shown to be well tolerated.
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9
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Liu M, Dudley SC. Magnesium, Oxidative Stress, Inflammation, and Cardiovascular Disease. Antioxidants (Basel) 2020; 9:E907. [PMID: 32977544 PMCID: PMC7598282 DOI: 10.3390/antiox9100907] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022] Open
Abstract
Hypomagnesemia is commonly observed in heart failure, diabetes mellitus, hypertension, and cardiovascular diseases. Low serum magnesium (Mg) is a predictor for cardiovascular and all-cause mortality and treating Mg deficiency may help prevent cardiovascular disease. In this review, we discuss the possible mechanisms by which Mg deficiency plays detrimental roles in cardiovascular diseases and review the results of clinical trials of Mg supplementation for heart failure, arrhythmias and other cardiovascular diseases.
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Affiliation(s)
- Man Liu
- Division of Cardiology, Department of Medicine, the Lillehei Heart Institute, University of Minnesota at Twin Cities, Minneapolis, MN 55455, USA
| | - Samuel C. Dudley
- Division of Cardiology, Department of Medicine, the Lillehei Heart Institute, University of Minnesota at Twin Cities, Minneapolis, MN 55455, USA
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10
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Barragán R, Llopis J, Portolés O, Sorlí JV, Coltell O, Rivas-García L, Asensio EM, Ortega-Azorín C, Corella D, Sánchez-González C. Influence of Demographic and Lifestyle Variables on Plasma Magnesium Concentrations and Their Associations with Cardiovascular Risk Factors in a Mediterranean Population. Nutrients 2020; 12:nu12041018. [PMID: 32276338 PMCID: PMC7230301 DOI: 10.3390/nu12041018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
Several studies have shown that a low magnesium (Mg) intake in the diet is associated with greater cardiovascular risk and greater risk of diabetes. However, the results are not consistent in all populations. To minimize the biases derived from diet measurement, more objective biomarkers of magnesium status have been proposed. Although there is still no ideal biomarker for Mg, several studies have shown that plasma Mg concentrations could be a relatively acceptable biomarker for cardiovascular risk assessment. However, further studies are required to better characterize this marker in different populations. Our aim was to analyze the association between plasma Mg concentrations (measured through inductively coupled plasma mass spectrometry (ICP-MS)) methods, and cardiovascular risk factors in individuals from a general Mediterranean population (aged 18–80 years). The influence of demographic and lifestyle variables, including adherence to the Mediterranean diet, on plasma Mg concentrations was analyzed. The mean Mg level of the population studied was 0.77 ± 0.08 mmol/L, the prevalence of hypomagnesemia (<0.70 mmol/L) being 18.6%. We did not find any statistically significant differences between plasma Mg concentrations and sex, age, tobacco smoking and total adherence to the Mediterranean diet (p > 0.05). We found a statistically significant association between plasma Mg concentrations and the prevalence of type-2 diabetes (0.77 ± 0.08 mmol/L in non-diabetics versus 0.73 ± 0.13 mmol/L in diabetics; p = 0.009). Despite the low prevalence of type-2 diabetes in this population (11.24% in subjects with hypomagnesemia versus 3.91%, in normomagnesemia; p = 0.005), hypomagnesemia was associated with greater odds of being diabetic in comparison with normomagnesemia (OR = 3.36; p = 0.016, even after adjustment for sex, age, obesity, and medications). On the other hand, no statistically significant association of plasma Mg concentrations with obesity, hypertension, fasting triglycerides, HDL-cholesterol or uric acid was found. However, in contrast to what was initially expected, a statistically significant association was found between plasma Mg concentrations (basically in the highest quartile) and greater total cholesterol (p < 0.05) and LDL-cholesterol concentrations (p < 0.05). In conclusion, our results contribute to increasing the evidence gathered by numerous studies on the inverse association between hypomagnesemia and type-2 diabetes, as well as to the observation, previously reported in some studies, of a direct association with hypercholesterolemia. This paradoxical link should be deeply investigated in further studies.
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Affiliation(s)
- Rocío Barragán
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Juan Llopis
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
| | - Olga Portolés
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Jose V. Sorlí
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Oscar Coltell
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Computer Languages and Systems, Universitat Jaume I, 12071 Castellón, Spain
| | - Lorenzo Rivas-García
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
| | - Eva M. Asensio
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Carolina Ortega-Azorín
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Dolores Corella
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence: ; Tel.: +34-96-386-4800
| | - Cristina Sánchez-González
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
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11
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Wu WC, Huang M, Taveira TH, Roberts MB, Martin LW, Wellenius GA, Johnson KC, Manson JE, Liu S, Eaton CB. Relationship Between Dietary Magnesium Intake and Incident Heart Failure Among Older Women: The WHI. J Am Heart Assoc 2020; 9:e013570. [PMID: 32192409 PMCID: PMC7428611 DOI: 10.1161/jaha.119.013570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Women represent a large proportion of the growing heart failure (HF) epidemic, yet data are lacking regarding optimal dietary and lifestyle prevention strategies for them. Specifically, the association between magnesium intake and HF in a multiracial cohort of women is uncertain. Methods and Results We included 97 725 postmenopausal women from the WHI (Women's Health Initiative) observational studies and placebo arms of the hormone trial. Magnesium intake was measured at baseline by a 122‐item validated food‐frequency questionnaire and stratified into quartiles based on diet only, total intake (diet with supplements), and residual intake (calibration by total energy). Incident hospitalized HF (2153 events, median follow‐up 8.1 years) was adjudicated by medical record abstraction. In Cox proportional hazards models, we evaluated the association between magnesium intake and HF adjusting for potential confounders. Analyses were repeated on a subcohort (n=18 745; median‐follow‐up, 13.2 years) for whom HF cases were subclassified into preserved ejection fraction (526 events), reduced ejection fraction (291 events) or unknown (168 events). Most women were white (85%) with a mean age of 63. Compared with the highest quartile of magnesium intake, women in the lowest quartile had an increased risk of incident HF, with adjusted hazard ratios of 1.32 (95% CI, 1.02–1.71) for diet only (P trend=0.03), 1.26 (95% CI, 1.03–1.56) for total intake, and 1.31 (95% CI, 1.02–1.67) for residual intake. Results did not significantly vary by race. Subcohort analyses showed low residual magnesium intake was associated with HF with reduced ejection fraction (hazard ratio, 1.81, lowest versus highest quartile; 95% CI, 1.08–3.05) but not HF with preserved ejection fraction. Conclusions Low magnesium intake in a multiracial cohort of postmenopausal women was associated with a higher risk of incident HF, especially HF with reduced ejection fraction.
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Affiliation(s)
- Wen-Chih Wu
- Division of Cardiology Veterans Affairs Medical Center & The Miriam Hospital Alpert Medical School Brown University Providence RI.,Department of Epidemiology Brown University School of Public Health Providence RI
| | - Mengna Huang
- Channing Division of Network Medicine Brigham and Women's Hospital Boston MA
| | - Tracey H Taveira
- Division of Cardiology Veterans Affairs Medical Center & The Miriam Hospital Alpert Medical School Brown University Providence RI.,University of Rhode Island, College of Pharmacy Kingston RI
| | - Mary B Roberts
- Center for Primary Care and Prevention and the Department of Family Medicine Memorial Hospital of Rhode Island Pawtucket RI
| | - Lisa W Martin
- Division of Cardiology George Washington University School of Medicine and Health Sciences Washington DC
| | - Gregory A Wellenius
- Department of Epidemiology Brown University School of Public Health Providence RI
| | - Karen C Johnson
- Department of Preventive Medicine University of Tennessee Health Science Center Memphis TN
| | - JoAnn E Manson
- Brigham and Women's Hospital Harvard Medical School Boston MA
| | - Simin Liu
- Department of Epidemiology Brown University School of Public Health Providence RI
| | - Charles B Eaton
- Center for Primary Care and Prevention and the Department of Family Medicine Memorial Hospital of Rhode Island Pawtucket RI.,Department of Epidemiology Brown University School of Public Health Providence RI
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12
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A Unique Formulation of Cardioprotective Bio-Actives: An Overview of Their Safety Profile. MEDICINES (BASEL, SWITZERLAND) 2019; 6:medicines6040107. [PMID: 31652632 PMCID: PMC6963456 DOI: 10.3390/medicines6040107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
The burden of cardiovascular disease (CVD) remains high globally and in the United States despite the availability of pharmaceuticals aimed at its prevention and treatment. An invention by Summit Innovation Labs, which is a formula consisting of a unique blend of select polyphenols (i.e., curcumin, quercetin, resveratrol), vitamin K2 as menaquinone-7, and magnesium, was recently developed to modulate the impact of the specific drivers of CVD, namely, vascular calcification, oxidative stress, and chronic inflammation. The SIL formulation is a dietary supplement that was designed leveraging the more bioavailable forms of ingredients with poor absorption, such as curcumin and quercetin. Each ingredient within the SIL formulation has been shown to contribute to CVD risk reduction by moderating the effect of CVD triggers, thereby providing a holistic prevention strategy for CVD in the healthy population. This review focuses on recently published clinical data to support the safety profile of these ingredients following oral administration. The preponderance of clinical trial data reviewed support the overall safety of the bioactives when used singly or in combination. The most commonly reported adverse effects were generally mild dose-related gastrointestinal disturbances, which may be alleviated with diet in some cases. In light of these, we conclude that the combination of the ingredients in the SIL formulation is reasonably expected to be safe.
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Gromova OA, Torshin IY, Kobalava ZD, Nazarenko AG. [Systematic Analysis of the Roles of Trace Elements in the Prevention and Treatment of Chronic Heart Failure]. ACTA ACUST UNITED AC 2019; 59:26-34. [PMID: 31242838 DOI: 10.18087/cardio.2019.6.n683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 11/18/2022]
Abstract
Systematic analysis of 3 728 publications on the relationship between microelement status and chronic heart failure (CHF) was carried out. Three main areas of research have been identified: 1) magnesium, electrolytes and CHF; 2) the transcriptional and antioxidant effects of zinc, selenium, copper; 3) iron-deficiency anemia and CHF. In this paper, we consider a complex of relationships between the magnesium insufficiency and CHF, the effect of magnesium on vascular tone, mitochondria, heart rhythm and the susceptibility of cardiomyocytes to adrenergic stimulation. Using magnesium orotate for the treatment of CHF is a feasible approach to compensate magnesium insufficiency in patients with CHF.
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Affiliation(s)
- O A Gromova
- Federal Research Center for Informatics and Management; Center for Big Data Storage and Analysis, Moscow State University
| | - I Yu Torshin
- Federal Research Center for Informatics and Management; Center for Big Data Storage and Analysis, Moscow State University
| | | | - A G Nazarenko
- N. N. Burdenko National Scientific and Practical Center for Neurosurgery
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Liu S, Liu Q. Personalized magnesium intervention to improve vitamin D metabolism: applying a systems approach for precision nutrition in large randomized trials of diverse populations. Am J Clin Nutr 2018; 108:1159-1161. [PMID: 30541094 PMCID: PMC6290361 DOI: 10.1093/ajcn/nqy294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/24/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Simin Liu
- Departments of Epidemiology, Medicine, and Surgery, and Center for Global Cardiometabolic Health, Brown University, Providence, RI,Department of Endocrinology, GuangDong General Hospital and Academy of Medical Sciences, Guangzhou, China,Address correspondence to SL (e-mail: )
| | - Qing Liu
- Departments of Epidemiology, Medicine, and Surgery, and Center for Global Cardiometabolic Health, Brown University, Providence, RI
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Beneficial Role of Mg 2+ in Prevention and Treatment of Hypertension. Int J Hypertens 2018; 2018:9013721. [PMID: 29992053 PMCID: PMC6016150 DOI: 10.1155/2018/9013721] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/23/2018] [Accepted: 05/16/2018] [Indexed: 02/07/2023] Open
Abstract
Hypertension constitutes one of the most widespread pathological conditions in developed and developing countries. Currently, more than 1 billion people worldwide are affected by the condition, either as frank hypertension or as prehypertension, raising the risk for major long-term complications and life-threatening pathologies. The costs in terms of health care services, medications for the treatment of hypertension and its complications, and associated loss in productivity represent a major economic burden for the various countries. The necessity of developing treatments that are economically more sustainable and with better compliance has been increasing alongside the incidence of the pathology. Along these lines, attention has been paid to the implementation of affordable but nutritious diets that deliver appropriate levels of macro- and micronutrients as integral part of the diets themselves or as supplements. In particular, experimental and clinical evidence suggests that an appropriate intake of dietary magnesium can be beneficial in controlling blood pressure. Additional advantages of a more diffuse therapeutic and/or preventive utilization of magnesium supplements are the virtual absence of side-effects and their affordable costs. The present review will attempt to frame our knowledge of how magnesium exerts its beneficial effects on blood pressure maintenance, which may lead to the development of more effective treatments of hypertension and its main complications.
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Han H, Fang X, Wei X, Liu Y, Jin Z, Chen Q, Fan Z, Aaseth J, Hiyoshi A, He J, Cao Y. Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: a systematic review and meta-analysis of prospective cohort studies. Nutr J 2017; 16:26. [PMID: 28476161 PMCID: PMC5420140 DOI: 10.1186/s12937-017-0247-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 04/18/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The findings of prospective cohort studies are inconsistent regarding the association between dietary magnesium intake and serum magnesium concentration and the risk of hypertension. We aimed to review the evidence from prospective cohort studies and perform a dose-response meta-analysis to investigate the relationship between dietary magnesium intake and serum magnesium concentrations and the risk of hypertension. METHODS We searched systematically PubMed, EMBASE and the Cochrane Library databases from October 1951 through June 2016. Prospective cohort studies reporting effect estimates with 95% confidence intervals (CIs) for hypertension in more than two categories of dietary magnesium intake and/or serum magnesium concentrations were included. Random-effects models were used to combine the estimated effects. RESULTS Nine articles (six on dietary magnesium intake, two on serum magnesium concentration and one on both) of ten cohort studies, including 20,119 cases of hypertension and 180,566 participates, were eligible for inclusion in the meta-analysis. We found an inverse association between dietary magnesium intake and the risk of hypertension [relative risk (RR) = 0.92; 95% CI: 0.86, 0.98] comparing the highest intake group with the lowest. A 100 mg/day increment in magnesium intake was associated with a 5% reduction in the risk of hypertension (RR = 0.95; 95% CI: 0.90, 1.00). The association of serum magnesium concentration with the risk of hypertension was marginally significant (RR = 0.91; 95% CI: 0.80, 1.02). CONCLUSIONS Current evidence supports the inverse dose-response relationship between dietary magnesium intake and the risk of hypertension. However, the evidence about the relationship between serum magnesium concentration and hypertension is limited.
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Affiliation(s)
- Hedong Han
- Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, Box 210, Stockholm, 17 177, Sweden.
| | - Xin Wei
- Mount Sinai St. Luke's and West Medical Center, 1111 Amsterdam Ave., New York, NY, 10025, USA
| | - Yuzhou Liu
- Mount Sinai St. Luke's and West Medical Center, 1111 Amsterdam Ave., New York, NY, 10025, USA
| | - Zhicao Jin
- Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Qi Chen
- Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jan Aaseth
- Faculty of Public Health, Hedmark University of Applied Sciences, 2411, Elverum, Norway.,Innlandet Hospital Trust, Kongsvinger Hospital Division, 2226, Kongsvinger, Norway
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 82, Örebro, Sweden
| | - Jia He
- Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China.
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, Box 210, Stockholm, 17 177, Sweden.,Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 82, Örebro, Sweden
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Costello RB, Elin RJ, Rosanoff A, Wallace TC, Guerrero-Romero F, Hruby A, Lutsey PL, Nielsen FH, Rodriguez-Moran M, Song Y, Van Horn LV. Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come. Adv Nutr 2016; 7:977-993. [PMID: 28140318 PMCID: PMC5105038 DOI: 10.3945/an.116.012765] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.
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Affiliation(s)
| | - Ronald J Elin
- Department of Pathology and Laboratory Medicine, University of Louisville, KY
| | | | - Taylor C Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA
| | | | - Adela Hruby
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Pamela L Lutsey
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | | | | | - Yiqing Song
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN; and
| | - Linda V Van Horn
- Division of Nutrition, Department of Preventive Medicine, Northwestern University, Chicago, IL
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18
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Dalton LM, Ní Fhloinn DM, Gaydadzhieva GT, Mazurkiewicz OM, Leeson H, Wright CP. Magnesium in pregnancy. Nutr Rev 2016; 74:549-57. [PMID: 27445320 DOI: 10.1093/nutrit/nuw018] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Magnesium deficiency is prevalent in women of childbearing age in both developing and developed countries. The need for magnesium increases during pregnancy, and the majority of pregnant women likely do not meet this increased need. Magnesium deficiency or insufficiency during pregnancy may pose a health risk for both the mother and the newborn, with implications that may extend into adulthood of the offspring. The measurement of serum magnesium is the most widely used method for determining magnesium levels, but it has significant limitations that have both hindered the assessment of deficiency and affected the reliability of studies in pregnant women. Thus far, limited studies have suggested links between magnesium inadequacy and certain conditions in pregnancy associated with high mortality and morbidity, such as gestational diabetes, preterm labor, preeclampsia, and small for gestational age or intrauterine growth restriction. This review provides recommendations for further study and improved testing using measurement of red cell magnesium. Pregnant women should be counseled to increase their intake of magnesium-rich foods such as nuts, seeds, beans, and leafy greens and/or to supplement with magnesium at a safe level.
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Affiliation(s)
- Lynne M Dalton
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland
| | - Deirdre M Ní Fhloinn
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland
| | - Gergana T Gaydadzhieva
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland
| | - Ola M Mazurkiewicz
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland
| | - Heather Leeson
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland
| | - Ciara P Wright
- L.M. Dalton, D.M. Ní Fhloinn, G.T. Gaydadzhieva, and O.M. Mazurkiewicz are with the Institute of Health Sciences, Dublin, Ireland. H. Leeson and C.P Wright are with Glenville Nutrition Ireland, Dublin, Ireland. C.P Wright is with MEDIVICE Independent Research, Dublin, Ireland.
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Ugwuja EI, Famurewa AC, Ikaraoha CI. Comparison of Serum Calcium and Magnesium Between Preeclamptic and Normotensive Pregnant Nigerian Women in Abakaliki, Nigeria. Ann Med Health Sci Res 2016; 6:33-7. [PMID: 27144074 PMCID: PMC4849113 DOI: 10.4103/2141-9248.180269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Evidence suggests the involvement of calcium and magnesium metabolism in the pathophysiology of preeclampsia. However, findings from studies are heterogenous and inconsistent. Aim: The study aimed to compare the total serum calcium and magnesium levels in preeclamptic women with that of normotensive pregnant women. Subjects and Methods: A cross-sectional subjects of eighty pregnant women living in Abakaliki, Ebonyi state, South-East Nigeria, were recruited into the study. The present study compared serum calcium and magnesium in forty preeclamptic (cases) and forty normotensive (control) pregnant women matched for age, parity, and socioeconomic status. Serum calcium and magnesium levels were measured using atomic absorption spectrophotometer. Statistical analysis was done using SPSS Version 20 statistical software. Differences between means were compared using Student's t-test with P < 0.05 considered as statistically significant. Results: While the mean serum calcium was comparable between preeclamptic and normotensive pregnant women (13.99 [3.29] vs. 14.02 [5.68] μg/dl), the preeclamptic pregnant women have significantly (P < 0.001) lower serum magnesium in comparison to their normotensive counterparts (3.22 [1.05] vs. 4.15 [0.78]). Conclusion: It may be concluded that serum magnesium seems to play a crucial role in the pathophysiology of preeclampsia in this environment.
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Affiliation(s)
- E I Ugwuja
- Department of Chemical Pathology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
| | - A C Famurewa
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, Federal University Ndufu-Alike Ikwo, Abakaliki, Ebonyi, Nigeria
| | - C I Ikaraoha
- Department of Chemical Pathology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
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Rosa-Diez G, Negri AL, Crucelegui MS, Philippi R, Perez-Teysseyre H, Sarabia-Reyes C, Loor-Navarrete H, Heguilen R. Sevelamer carbonate reduces the risk of hypomagnesemia in hemodialysis-requiring end-stage renal disease patients. Clin Kidney J 2016; 9:481-5. [PMID: 27274837 PMCID: PMC4886916 DOI: 10.1093/ckj/sfw021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/23/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sevelamer has been associated with less progression of vascular calcifications. This effect could be due to a reduction in serum phosphate levels but also to other additive effects. Magnesium has been also shown to prevent vascular calcification but the effect of sevelamer on serum magnesium levels has not been thoroughly evaluated. Our aim was to analyze whether the use of sevelamer reduces the risk of hypomagnesemia in hemodialysis (HD)-requiring end-stage renal disease patients. METHODS All prevalent patients from the dialysis unit of the Hospital Italiano de Buenos Aires as of 1 June 2015 were evaluated. They were on three times per week bicarbonate/citrate-buffered HD. They were not receiving phosphate binders or magnesium-containing drugs. The average of three successive monthly magnesium serum levels was considered as the baseline magnesium concentration. Sevelamer carbonate use was retrieved from the patient's clinical records. RESULTS One hundred and fifty-one patients were included. A large proportion of individuals were on proton pump inhibitors (PPIs) (66%) and more than 50% were using sevelamer carbonate. Serum magnesium levels were significantly higher in those receiving sevelamer compared with those who did not (2.05 ± 0.3 versus 1.8 ± 0.4 mg/dL; P < 0.05). A larger proportion of individuals receiving sevelamer were among those with normal serum magnesium (P = 0.02), while among those with hypomagnesemia, a larger proportion were on PPIs. In the multivariate model including the use of PPIs, sevelamer carbonate resulted in an independent protective factor for hypomagnesemia (odds ratio: 0.44; 95% confidence interval: 0.21-0.87). CONCLUSIONS Hemodialysis patients receiving sevelamer show higher serum magnesium levels and a reduced risk of hypomagnesemia. This effect remains even after adjustment for PPI use. This effect could contribute to the still controversial superiority of sevelamer in preventing vascular calcifications.
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Affiliation(s)
- Guillermo Rosa-Diez
- Servicio de Nefrología , Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Armando Luis Negri
- Instituto de Diagnostico e Investigaciones Metabólicas , Universidad del Salvador , Buenos Aires , Argentina
| | | | - Romina Philippi
- Servicio de Nefrología , Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | | | - Carmen Sarabia-Reyes
- Servicio de Nefrología , Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Henry Loor-Navarrete
- Servicio de Nefrología , Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Ricardo Heguilen
- Servicio de Nefrología , Hospital Juan A. Fernández , Buenos Aires , Argentina
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21
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Taveira TH, Ouellette D, Gulum A, Choudhary G, Eaton CB, Liu S, Wu WC. Relation of Magnesium Intake With Cardiac Function and Heart Failure Hospitalizations in Black Adults: The Jackson Heart Study. Circ Heart Fail 2016; 9:e002698. [PMID: 27056880 PMCID: PMC4826717 DOI: 10.1161/circheartfailure.115.002698] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 03/07/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Little is known about magnesium intake and risk of heart failure (HF) hospitalizations, particularly in blacks. We hypothesize that magnesium intake relates to HF hospitalization in blacks. METHODS AND RESULTS From the Jackson Heart Study cohort (n=5301), we studied 4916 blacks recruited during 2000 to 2004 in Jackson (Mississippi), who completed an 158-item Food-Frequency Questionnaire that included dietary supplements. Daily magnesium intake derived from the questionnaire was divided by the body weight to account for body storage and stratified by quartiles (0.522-2.308, 2.309-3.147, 3.148-4.226, and ≥4.227 mg magnesium intake/kg). Cox proportional hazards modeling assessed the association between quartiles of magnesium intake/kg and hospitalizations for HF adjusting for HF risk, energy intake, and dietary factors. The cohort had a mean age=55.3 (SD=12.7 years) and composed of 63.4% women, 21.6% diabetes mellitus, 62.7% hypertension, 7.1% coronary disease, and 2.8% with known HF. When compared with participants in the first quartile of magnesium intake/kg, those with higher magnesium intake (>2.308 mg/kg) had decreased risk of HF admission, with adjusted hazard ratios of 0. 66(95% confidence interval, 0.47-0.94) in the second quartile to 0.47 (95% confidence interval, 0.27-0.82) in the highest quartile. Results were similar when individuals with previously diagnosed HF (2.8%) were excluded or when the analysis was repeated using quartiles of magnesium intake without accounting for body weight. CONCLUSIONS Magnesium intake <2.3 mg/kg was related to increased risk of subsequent HF hospitalizations. Future studies are needed to test whether serum magnesium levels predict risk of HF.
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Affiliation(s)
- Tracey H Taveira
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Danielle Ouellette
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Alev Gulum
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Gaurav Choudhary
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Charles B Eaton
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Simin Liu
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Wen-Chih Wu
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles.
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Chan Q, Stamler J, Oude Griep LM, Daviglus ML, Van Horn L, Elliott P. An Update on Nutrients and Blood Pressure. J Atheroscler Thromb 2015; 23:276-89. [PMID: 26686565 PMCID: PMC6323301 DOI: 10.5551/jat.30000] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Adverse blood pressure (BP) is a major independent risk factor for epidemic cardiovascular diseases affecting almost one-quarter of the adult population worldwide. Dietary intake is a major determinant in the development and progression of high BP. Lifestyle modifications, including recommended dietary guidelines, are advocated by the American Society of Hypertension, the International Society of Hypertension, the Japanese Society of Hypertension, and many other organisations for treating all hypertensive people, prior to initiating drug therapy and as an adjunct to medication in persons already on drug therapy. Lifestyle modification can also reduce high BP and prevent development of hypertension. This review synthesizes results from the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP), a cross-sectional epidemiological study of 4,680 men and women aged 40-59 years from Japan, the People's Republic of China, the United Kingdom, and the United States, published over the past few years on cross cultural BP differences. INTERMAP has previously reported that intakes of vegetable protein, glutamic acid, total and insoluble fibre, total polyunsaturated fatty acid and linoleic acid, total n-3 fatty acid and linolenic acid, phosphorus, calcium, magnesium, and non-heme iron were inversely related to BP. Direct associations of sugars (fructose, glucose, and sucrose) and sugar-sweetened beverages (especially combined with high sodium intake), cholesterol, glycine, alanine, and oleic acid from animal sources with BP were also reported by the INTERMAP Study.
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Affiliation(s)
- Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Linda M. Oude Griep
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Martha L. Daviglus
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Minority Health Research, University of Chicago, IL, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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Abstract
BACKGROUND Although magnesium is important in the biology of blood pressure regulation, little clinical data exist on the association of hypermagnesemia and blood pressure. METHOD We examined the association of hypermagnesemia and SBP in a cross-sectional study of 10 521 ICU patients from a single tertiary care medical center, 6% of whom had a serum magnesium above 2.6 mg/dl at time of admission. RESULTS In a multivariable analysis, hypermagnesemia was associated with SBP 6.2 mmHg lower [95% confidence interval (CI) -8.2, -4.2, P < 0.001] than in patients with admission values of serum magnesium 2.6 mg/dl or less. Each mg/dl increase in serum magnesium was associated with a decrease in SBP of 4.3 mmHg (95% CI -5.5, -3.1, P < 0.001). In addition, hypermagnesemic patients had a 2.48-fold greater likelihood (95% CI 2.06, 3.00, P < 0.001) of receiving intravenous vasopressors during the first 24 h of ICU care, independent of admission SBP. CONCLUSION Our findings add support to the biologic importance of magnesium regulation in blood pressure control.
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Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients 2015; 7:8199-226. [PMID: 26404370 PMCID: PMC4586582 DOI: 10.3390/nu7095388] [Citation(s) in RCA: 431] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/16/2015] [Accepted: 09/11/2015] [Indexed: 12/15/2022] Open
Abstract
Magnesium is the fourth most abundant mineral in the body. It has been recognized as a cofactor for more than 300 enzymatic reactions, where it is crucial for adenosine triphosphate (ATP) metabolism. Magnesium is required for DNA and RNA synthesis, reproduction, and protein synthesis. Moreover, magnesium is essential for the regulation of muscular contraction, blood pressure, insulin metabolism, cardiac excitability, vasomotor tone, nerve transmission and neuromuscular conduction. Imbalances in magnesium status—primarily hypomagnesemia as it is seen more common than hypermagnesemia—might result in unwanted neuromuscular, cardiac or nervous disorders. Based on magnesium’s many functions within the human body, it plays an important role in prevention and treatment of many diseases. Low levels of magnesium have been associated with a number of chronic diseases, such as Alzheimer’s disease, insulin resistance and type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and attention deficit hyperactivity disorder (ADHD).
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Affiliation(s)
- Uwe Gröber
- Academy of Micronutrient Medicine, Essen 45130, Germany.
| | | | - Klaus Kisters
- Academy of Micronutrient Medicine, Essen 45130, Germany.
- Department of Internal Medicine I, St. Anna-Hospital, Herne 44649, Germany.
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Li L, Streja E, Rhee CM, Mehrotra R, Soohoo M, Brunelli SM, Kovesdy CP, Kalantar-Zadeh K. Hypomagnesemia and Mortality in Incident Hemodialysis Patients. Am J Kidney Dis 2015; 66:1047-55. [PMID: 26184377 DOI: 10.1053/j.ajkd.2015.05.024] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/20/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND In the general population, low serum magnesium levels are associated with poor outcomes and death. While limited data suggest that low baseline magnesium levels may be associated with higher mortality in hemodialysis (HD) patients, the impact of changes in magnesium levels over time is unknown. STUDY DESIGN We examined the association of time-varying serum magnesium levels with all-cause mortality using multivariable time-varying survival models adjusted for clinical characteristics and other time-varying laboratory measures. SETTING & PARTICIPANTS 9,359 maintenance HD patients treated in a large dialysis organization between 2007 and 2011. PREDICTOR Time-varying serum magnesium levels across 5 magnesium increments (<1.8, 1.8-<2.0, 2.0-<2.2, 2.2-<2.4, and ≥2.4mg/dL). OUTCOME All-cause mortality. RESULTS 2,636 individuals died over 5 years. Time-varying serum magnesium levels < 2.0mg/dL were associated with higher mortality after adjustment for demographics and comorbid conditions, including hypertension, diabetes, and malignancies (reference: magnesium, 2.2-<2.4mg/dL): adjusted HRs for serum magnesium level < 1.8 and 1.8 to <2.0mg/dL were 1.39 (95% CI, 1.23-1.58; P<0.001) and 1.20 (95% CI, 1.06-1.36; P=0.004), respectively. Some associations were attenuated to the null after incremental adjustment for laboratory test results, particularly serum albumin. However, among patients with serum albumin measurements, low albumin level (<3.5g/dL) and magnesium level < 2.0mg/dL were associated with an additional death risk (adjusted HR, 1.17; 95% CI, 1.05-1.31; P=0.004), whereas patients with high serum albumin levels (≥3.5g/dL) exhibited low death risk (adjusted HRs of 0.53 and 0.53 [P≤0.001] for magnesium < 2.0 and ≥2.0mg/dL, respectively; reference: albumin < 3.5g/dL and magnesium ≥ 2.0mg/dL). LIMITATIONS Causality cannot be determined, and residual confounding cannot be excluded given the observational study design. CONCLUSIONS Lower serum magnesium levels are associated with higher mortality in HD patients, including those with hypoalbuminemia. Interventional studies are warranted to examine whether correction of hypomagnesemia ameliorates adverse outcomes in this population.
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Affiliation(s)
- Lin Li
- Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA
| | - Connie M Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA
| | - Rajnish Mehrotra
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA
| | - Melissa Soohoo
- Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA
| | | | - Csaba P Kovesdy
- Division of Nephrology, Memphis Veterans Affairs Medical Center, Memphis, TN
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA.
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27
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Abstract
Although the following text will focus on magnesium in disease, its role in healthy subjects during physical exercise when used as a supplement to enhance performance is also noteworthy. Low serum magnesium levels are associated with metabolic syndrome, Type 2 diabetes mellitus (T2DM) and hypertension; consequently, some individuals benefit from magnesium supplementation: increasing magnesium consumption appears to prevent high blood pressure, and higher serum magnesium levels are associated with a lower risk of developing a metabolic syndrome. There are, however, conflicting study results regarding magnesium administration with myocardial infarction with and without reperfusion therapy. There was a long controversy as to whether or not magnesium should be given as a first-line medication. As the most recent trials have not shown any difference in outcome, intravenous magnesium cannot be recommended in patients with myocardial infarction today. However, magnesium has its indication in patients with torsade de pointes and has been given successfully to patients with digoxin-induced arrhythmia or life-threatening ventricular arrhythmias. Magnesium sulphate as an intravenous infusion also has an important established therapeutic role in pregnant women with pre-eclampsia as it decreases the risk of eclamptic seizures by half compared with placebo.
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Affiliation(s)
- Helmut Geiger
- Klinikum der J.W. Goethe-Universität, Medizinische Klinik III/Nephrologie, Frankfurt/Main, Germany
| | - Christoph Wanner
- Universitätsklinik Würzburg, Medizinische Klinik und Poliklinik I, Würzburg, Germany
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28
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Kiberd BA, Tennankore KK, Daley CJA. Increases in intravenous magnesium use among hospitalized patients: an institution cross-sectional experience. Can J Kidney Health Dis 2015; 2:24. [PMID: 26106483 PMCID: PMC4477498 DOI: 10.1186/s40697-015-0056-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among hospitalized patients, indications for the measurement of magnesium levels and treatment of hypomagnesemia with intravenous magnesium are not well defined. Recently, there have been reports of worldwide shortages of intravenous magnesium sulphate. OBJECTIVE To examine secular trends in the administration of intravenous magnesium on hospital wards at a tertiary care institution. The secondary objective is to identify factors associated with magnesium use among admitted patients. METHODS Retrospective cross-section review of hospitalized patients at a single Canadian tertiary care center. Utilization of non-parental nutrition intravenous magnesium from 2003 to 2013 stratified by hospital ward was examined. In addition, patient level data from select wards (including medical and surgical services) was examined at early and more recent time period (4/2006 versus 4/2013). RESULTS Among the 248,329 hospitalized patients, intravenous magnesium use increased by 2.86 fold from 2003 to 2013. Not all wards had an increase whereas some had nearly a 10 fold increase in use. In the sample (n = 769), (adjusting for admission magnesium level, presence of an indication for intravenous magnesium, ward location, comorbidity and demographics) intravenous magnesium administration was higher (25.8 % versus 5.5 %) in 2013 versus 2006 (OR 13.91 (95 % CI, 6.21-31.17, p < 0.001). Despite this increase in intravenous magnesium administration, <3 % of patients were admitted on oral magnesium in 2006 and 2013. For patients receiving intravenous magnesium only a minority were discharged on oral therapy despite low levels. CONCLUSIONS This center has witnessed a considerable increase in the use of in-hospital intravenous magnesium over the last 6 years that cannot be explained for by medical indications. The risks and benefits of this therapy deserve further study. If this change in practice is representative of other North American hospitals, it may be responsible for recent drug shortages.
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Affiliation(s)
- Bryce A Kiberd
- Department of Medicine, Dalhousie University, Queen Elizabeth II Health Sciences-VG Site, Room 5082 Dickson Building, 5820 University Avenue, Halifax, Nova Scotia B3H 1V8 Canada
| | - Karthik K Tennankore
- Department of Medicine, Dalhousie University, Queen Elizabeth II Health Sciences-VG Site, Room 5070 Dickson Building, 5820 University Avenue, Halifax, Nova Scotia B3H 1V8 Canada
| | - Christopher J A Daley
- Pharm D. College of Pharmacy, Dalhousie University, Queen Elizabeth II Health Sciences-VG Site, Room 2043, 1276 South Park Street, Halifax, Nova Scotia B3H 2Y9 Canada
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Adebamowo SN, Spiegelman D, Willett WC, Rexrode KM. Association between intakes of magnesium, potassium, and calcium and risk of stroke: 2 cohorts of US women and updated meta-analyses. Am J Clin Nutr 2015; 101:1269-77. [PMID: 25948665 PMCID: PMC4441806 DOI: 10.3945/ajcn.114.100354] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 04/02/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Prospective data on the relation of magnesium, potassium, and calcium intakes with stroke risk are inconsistent, and to our knowledge, the effect of a combined mineral diet score has not been examined. OBJECTIVE We examined associations between intakes of magnesium, potassium, and calcium and risk of incident stroke in 86,149 women in the Nurses' Health Study (NHS) I and 94,715 women in the NHS II. DESIGN In this prospective cohort study, we calculated HRs of stroke by quintiles of intake for each mineral and for a combined diet score of all 3 minerals by using multivariate Cox proportional hazard models. In addition, we updated meta-analyses on dietary intakes of these minerals and risk of stroke. RESULTS During follow-up (30 y in the NHS I; 22 y in the NHS II) a total of 3780 incident stroke cases were documented. Pooled multivariate RRs of total stroke for women in the highest compared with the lowest quintiles were 0.87 (95% CI: 0.78, 0.97) for total magnesium, 0.89 (95% CI: 0.80, 0.99) for total potassium, and 0.97 (95% CI: 0.87, 1.09) for total calcium intake. Pooled RRs for women in the highest compared with the lowest quintiles of a combined mineral diet score were 0.72 (95% CI: 0.65, 0.81) for total stroke, 0.78 (95% CI: 0.66, 0.92) for ischemic stroke, and 0.80 (95% CI: 0.61, 1.04) for hemorrhagic stroke. In the updated meta-analyses of all prospective studies to date, the combined RR of total stroke was 0.87 (95% CI: 0.83, 0.92) for a 100-mg/d increase in magnesium intake, 0.91 (95% CI: 0.88, 0.94) for a 1000-mg/d increase in potassium intake, and 0.98 (95% CI: 0.94, 1.02) for a 300-mg/d increase in calcium intake. CONCLUSIONS A combined mineral diet score was inversely associated with risk of stroke. High intakes of magnesium and potassium but not calcium were also significantly associated with reduced risk of stroke in women.
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Affiliation(s)
- Sally N Adebamowo
- From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (SNA and KMR); the Departments of Department of Nutrition (SNA, DS, and WCW), Biostatistics (DS), Epidemiology (DS and WCW), and Global Health and Population (DS), Harvard T.H. Chan School of Public Health, Boston, MA; and the Channing Division of Network Medicine, Boston, MA (WCW).
| | - Donna Spiegelman
- From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (SNA and KMR); the Departments of Department of Nutrition (SNA, DS, and WCW), Biostatistics (DS), Epidemiology (DS and WCW), and Global Health and Population (DS), Harvard T.H. Chan School of Public Health, Boston, MA; and the Channing Division of Network Medicine, Boston, MA (WCW)
| | - Walter C Willett
- From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (SNA and KMR); the Departments of Department of Nutrition (SNA, DS, and WCW), Biostatistics (DS), Epidemiology (DS and WCW), and Global Health and Population (DS), Harvard T.H. Chan School of Public Health, Boston, MA; and the Channing Division of Network Medicine, Boston, MA (WCW)
| | - Kathryn M Rexrode
- From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (SNA and KMR); the Departments of Department of Nutrition (SNA, DS, and WCW), Biostatistics (DS), Epidemiology (DS and WCW), and Global Health and Population (DS), Harvard T.H. Chan School of Public Health, Boston, MA; and the Channing Division of Network Medicine, Boston, MA (WCW)
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Huth PJ, Fulgoni VL, Keast DR, Park K, Auestad N. Major food sources of calories, added sugars, and saturated fat and their contribution to essential nutrient intakes in the U.S. diet: data from the National Health and Nutrition Examination Survey (2003-2006). Nutr J 2013; 12:116. [PMID: 23927718 PMCID: PMC3751311 DOI: 10.1186/1475-2891-12-116] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 07/31/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The risk of chronic disease cannot be predicted simply by the content of a single nutrient in a food or food group in the diet. The contribution of food sources of calories, added sugars and saturated fat (SFA) to intakes of dietary fiber and micronutrients of public health importance is also relevant to understanding the overall dietary impact of these foods. OBJECTIVE Identify the top food sources of calories, added sugars and SFA in the U.S. diet and quantify their contribution to fiber and micronutrient intakes. METHODS Single 24-hour dietary recalls (Day 1) collected from participants ≥2 years (n = 16,822) of the What We Eat in America, National Health and Nutrition Examination Survey (WWEIA/NHANES 2003-2006) were analyzed. All analyses included sample weights to account for the survey design. Calorie and nutrient intakes from foods included contributions from disaggregated food mixtures and tabulated by rank order. RESULTS No one food category contributes more than 7.2% of calories to the overall U.S. diet, but half of the top 10 contribute 10% or more of total dietary fiber and micronutrients. Three of the top 10 sources of calories and SFA (beef, milk and cheese) contribute 46.3% of the calcium, 49.5% of the vitamin D, 42.3% of the vitamin B12 as well as other essential nutrients to the American diet. On the other hand, foods categorized as desserts, snacks, or beverages, contribute 13.6% of total calories, 83% of added sugar intake, and provide little or no nutritional value. Including food components of disaggregated recipes more accurately estimated the contribution of foods like beef, milk or cheese to overall nutrient intake compared to "as consumed" food categorizations. CONCLUSIONS Some food sources of calories, added sugars and SFA make major contributions to American dietary fiber and micronutrient intakes. Dietary modifications targeting reductions in calories, added sugar, or SFA need to take these key micronutrient sources into account so as not to have the unintended consequence of lowering overall dietary quality.
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Affiliation(s)
- Peter J Huth
- PJH Nutritional Science, N5001 565th Street, Menomonie 54751, WI, USA
| | - Victor L Fulgoni
- Nutrition Impact, LLC, 9725 D Drive North, 49014 Battle Creek, MI, USA
| | - Debra R Keast
- Food & Nutrition Database Research, Inc, 1801 Shadywood Lane, 48864 Okemos, MI, USA
| | - Keigan Park
- Nutrition Research, Dairy Research Institute, 10255 West Higgins Road, Suite 900, 60018 Rosemont, IL, USA
| | - Nancy Auestad
- Regulatory Affairs, Dairy Research Institute, 10255 West Higgins Road, Suite 900, 60018 Rosemont, IL, USA
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Abstract
Magnesium is the fourth most abundant mineral and the second most abundant intracellular divalent cation and has been recognized as a cofactor for >300 metabolic reactions in the body. Some of the processes in which magnesium is a cofactor include, but are not limited to, protein synthesis, cellular energy production and storage, reproduction, DNA and RNA synthesis, and stabilizing mitochondrial membranes. Magnesium also plays a critical role in nerve transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone, blood pressure, and glucose and insulin metabolism. Because of magnesium's many functions within the body, it plays a major role in disease prevention and overall health. Low levels of magnesium have been associated with a number of chronic diseases including migraine headaches, Alzheimer's disease, cerebrovascular accident (stroke), hypertension, cardiovascular disease, and type 2 diabetes mellitus. Good food sources of magnesium include unrefined (whole) grains, spinach, nuts, legumes, and white potatoes (tubers). This review presents recent research in the areas of magnesium and chronic disease, with the goal of emphasizing magnesium's role in disease prevention and overall health.
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Affiliation(s)
- Stella Lucia Volpe
- Department of Nutrition Sciences, Center for Integrated Nutrition & Performance College of Nursing and Health Professions Drexel University, Philadelphia, PA, USA.
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Nguyen H, Odelola OA, Rangaswami J, Amanullah A. A review of nutritional factors in hypertension management. Int J Hypertens 2013; 2013:698940. [PMID: 23691281 PMCID: PMC3649175 DOI: 10.1155/2013/698940] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/15/2013] [Indexed: 12/18/2022] Open
Abstract
Hypertension is a major health problem worldwide. Its attendant morbidity and mortality complications have a great impact on patient's quality of life and survival. Optimizing blood pressure control has been shown to improve overall health outcomes. In addition to pharmacological therapies, nonpharmacological approach such as dietary modification plays an important role in controlling blood pressure. Many dietary components such as sodium, potassium, calcium, and magnesium have been studied substantially in the past decades. While some of these nutrients have clear evidence for their recommendation, some remain controversial and are still of ongoing study. Dietary modification is often discussed with patients and can provide a great benefit in blood pressure regulation. As such, reviewing the current evidence will be very useful in guiding patients and their physician and/or dietician in decision making. In this review article of nutritional factors in hypertension management, we aim to examine the role of nutritional factors individually and as components of whole dietary patterns.
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Affiliation(s)
- Ha Nguyen
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Olaide A. Odelola
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Janani Rangaswami
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Aman Amanullah
- Noninvasive Cardiology, Albert Einstein Medical Center, Clinical Professor of Medicine, Jefferson Medical College of Thomas Jefferson University, 5501 Old York Road, HB-3, Philadelphia, PA 19141, USA
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Trimarco V, Cimmino CS, Santoro M, Pagnano G, Manzi MV, Piglia A, Giudice CA, De Luca N, Izzo R. Nutraceuticals for blood pressure control in patients with high-normal or grade 1 hypertension. High Blood Press Cardiovasc Prev 2013; 19:117-22. [PMID: 22994579 DOI: 10.1007/bf03262460] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Current hypertension management guidelines do not recommend drug treatment in subjects with blood pressure (BP) in the high-normal range due to the risk of side effects of the currently available antihypertensive agents that overcomes the possible benefit. Nutraceuticals are free from relevant side effects and could be a valuable strategy for the treatment of these patients. AIM The objective of this study was to compare the efficacy of two nutraceutical compositions given by the combination of policosanol, red yeast rice extract, berberine, folic acid and coenzyme Q(10) with or without Orthosiphon stamineus in lowering the BP and lipid profile. METHODS Thirty patients with grade 1 essential hypertension and low cardiovascular risk were analysed. At the end of a run-in period, patients were divided into two study arms and assigned to receive the nutraceutical combination with and without Orthosiphon stamineus. All participants underwent 24-hour ambulatory BP monitoring at the end of the run-in period and of the 4-week treatment with each of the two different nutraceutical combinations. RESULTS In patients treated with Orthosiphon stamineus a significant reduction of mean 24-hour systolic and diastolic BP levels compared with baseline values was registered and the smoothness index calculated for systolic and diastolic BP showed a more reliable and homogeneous effect on BP over 24 hours. In contrast, nutraceutical treatment without Orthosiphon stamineus was not associated with a significant reduction of BP. CONCLUSIONS Our results show that the addition of Orthosiphon stamineus to the combination of nutraceuticals confers an antihypertensive effect that allows a surprisingly effective 24-hour BP control in hypertensive patients.
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Affiliation(s)
- Valentina Trimarco
- Department of NeuroSciences, Federico II University, Via S. Pansini 5, Naples, Italy
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Trimarco V, Cimmino CS, Santoro M, Pagnano G, Manzi MV, Piglia A, Giudice CA, De Luca N, Izzo R. Nutraceuticals for blood pressure control in patients with high-normal or grade 1 hypertension. High Blood Press Cardiovasc Prev 2013. [PMID: 22994579 DOI: 10.2165/11632160-000000000-00000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Current hypertension management guidelines do not recommend drug treatment in subjects with blood pressure (BP) in the high-normal range due to the risk of side effects of the currently available antihypertensive agents that overcomes the possible benefit. Nutraceuticals are free from relevant side effects and could be a valuable strategy for the treatment of these patients. AIM The objective of this study was to compare the efficacy of two nutraceutical compositions given by the combination of policosanol, red yeast rice extract, berberine, folic acid and coenzyme Q(10) with or without Orthosiphon stamineus in lowering the BP and lipid profile. METHODS Thirty patients with grade 1 essential hypertension and low cardiovascular risk were analysed. At the end of a run-in period, patients were divided into two study arms and assigned to receive the nutraceutical combination with and without Orthosiphon stamineus. All participants underwent 24-hour ambulatory BP monitoring at the end of the run-in period and of the 4-week treatment with each of the two different nutraceutical combinations. RESULTS In patients treated with Orthosiphon stamineus a significant reduction of mean 24-hour systolic and diastolic BP levels compared with baseline values was registered and the smoothness index calculated for systolic and diastolic BP showed a more reliable and homogeneous effect on BP over 24 hours. In contrast, nutraceutical treatment without Orthosiphon stamineus was not associated with a significant reduction of BP. CONCLUSIONS Our results show that the addition of Orthosiphon stamineus to the combination of nutraceuticals confers an antihypertensive effect that allows a surprisingly effective 24-hour BP control in hypertensive patients.
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Affiliation(s)
- Valentina Trimarco
- Department of NeuroSciences, Federico II University, Via S. Pansini 5, Naples, Italy
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Rozza F, de Simone G, Izzo R, De Luca N, Trimarco B. Nutraceuticals for treatment of high blood pressure values in patients with metabolic syndrome. High Blood Press Cardiovasc Prev 2013; 16:177-82. [PMID: 23334909 DOI: 10.2165/11530420-000000000-00000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 09/12/2009] [Indexed: 12/28/2022] Open
Abstract
AIM To assess whether the association of a dietary supplement with a correct diet can decrease the incidence of metabolic syndrome. In particular, we studied the effect of a combination of Ortosiphon staminensis, which in rats exerts a diuretic effect, with policosanol, red yeast rice extract, berberine, folic acid and coenzyme Q(10) on the determinants of metabolic syndrome diagnosis. METHODS The analysed sample consisted of 21 males and 9 females, who were comparable in age, in order to obtain an adequate comparison between groups with similar demographic characteristics. Thirty patients with metabolic syndrome were divided into two study arms. Both groups received the usual diet recommended by the doctor according to their clinical conditions and placebo for 2 weeks before the beginning of the study, and then they were randomly assigned to two different drug regimens: placebo or the combination of nutraceuticals previously described, and were followed-up for 6 weeks. RESULTS At baseline, there were no significant differences between the study and control groups for age, sex distribution, waist measurement, body mass index, systolic and diastolic blood pressure, familiarity for cardiovascular events, smoking habit, fasting glucose and lipid profile.At the end of the follow-up, only in the study group was there a significant reduction in systolic and diastolic blood pressure (-19.6±9.7 vs -3.6±8.1 mmHg and -13.6±5.5 vs -2.3±5.3 mmHg; all p < 0.0001) associated with amarked decrease in low-density lipoprotein cholesterol and triglyceride plasma levels. Consequently, 10 of 15 patients in this group no longer satisfied the criteria for metabolic syndrome, while in the control group the ratio was of 2 of 15. CONCLUSIONS The addition of Ortosiphon staminensis to the combination of policosanol, red yeast rice extract, berberine, folic acid and coenzyme Q(10) provides an antihypertensive effect, which allows an effective control of blood pressure in patients with metabolic syndrome.
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Affiliation(s)
- Francesco Rozza
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Via Sergio Pansini 5, bld 2-, 80131, Naples, Italy
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Toledo E, Alonso Á, Martínez-González MÁ. Differential Association of Low-Fat and Whole-Fat Dairy Products with Blood Pressure and Incidence of Hypertension. Curr Nutr Rep 2012. [DOI: 10.1007/s13668-012-0026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Calcium, magnesium and potassium intake and mortality in women with heart failure: the Women's Health Initiative. Br J Nutr 2012. [PMID: 23199414 DOI: 10.1017/s0007114512004667] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although diet is thought to affect the natural history of heart failure (HF), nutrient intake in HF patients has not been well studied. Based on prior research linking high intake of Ca, Mg and K to improved cardiovascular health, we hypothesised that these nutrients would be inversely associated with mortality in people with HF. Of the 161 808 participants in the Women's Health Initiative (WHI), we studied 3340 who experienced a HF hospitalisation. These participants were followed for post-hospitalisation all-cause mortality. Intake was assessed using questionnaires on food and supplement intake. Hazard ratios (HR) and 95 % CI were calculated using Cox proportional hazards models adjusted for demographics, physical function, co-morbidities and dietary covariates. Over a median of 4·6 years of follow-up, 1433 (42·9 %) of the women died. HR across quartiles of dietary Ca intake were 1·00 (referent), 0·86 (95 % CI 0·73, 1·00), 0·88 (95 % CI 0·75, 1·04) and 0·92 (95 % CI 0·76, 1·11) (P for trend = 0·63). Corresponding HR were 1·00 (referent), 0·86 (95 % CI 0·71, 1·04), 0·88 (95 % CI 0·69, 1·11) and 0·84 (95 % CI 0·63, 1·12) (P for trend = 0·29), across quartiles of dietary Mg intake, and 1·00 (referent), 1·20 (95 % CI 1·01, 1·43), 1·06 (95 % CI 0·86, 1·32) and 1·16 (95 % CI 0·90, 1·51) (P for trend = 0·35), across quartiles of dietary K intake. Results were similar when total (dietary plus supplemental) nutrient intakes were examined. In summary, among WHI participants with incident HF hospitalisation, intakes of Ca, Mg and K were not significantly associated with subsequent mortality.
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Magnesium and vascular changes in hypertension. Int J Hypertens 2012; 2012:754250. [PMID: 22518291 PMCID: PMC3299255 DOI: 10.1155/2012/754250] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 12/19/2011] [Indexed: 12/15/2022] Open
Abstract
Many factors have been implicated in the pathogenesis of hypertension, including changes in intracellular concentrations of calcium, sodium, potassium, and magnesium. There is a significant inverse correlation between serum magnesium and incidence of cardiovascular diseases. Magnesium is a mineral with important functions in the body such as antiarrhythmic effect, actions in vascular tone, contractility, glucose metabolism, and insulin homeostasis. In addition, lower concentrations of magnesium are associated with oxidative stress, proinflammatory state, endothelial dysfunction, platelet aggregation, insulin resistance, and hyperglycemia. The conflicting results of studies evaluating the effects of magnesium supplements on blood pressure and other cardiovascular outcomes indicate that the action of magnesium in the vascular system is present but not yet established. Therefore, this mineral supplementation is not indicated as part of antihypertensive treatment, and further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases.
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Kass L, Weekes J, Carpenter L. Effect of magnesium supplementation on blood pressure: a meta-analysis. Eur J Clin Nutr 2012; 66:411-8. [PMID: 22318649 DOI: 10.1038/ejcn.2012.4] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To date, there has been inconclusive evidence regarding the effect of magnesium supplements on blood pressure (BP). This meta-analysis was conducted to assess the effect of magnesium supplementation on BP and to establish the characteristics of trials showing the largest effect size. Primary outcome measures were systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of the follow-up period. One hundred and forty-one papers were identified, of which 22 trials with 23 sets of data (n=1173), with 3 to 24 weeks of follow-up met the inclusion criteria, with a supplemented elemental magnesium range of 120-973 mg (mean dose 410 mg). 95% confidence intervals (CI) were calculated using DerSimonian and Laird's random-effects model, with effect size calculated using Hedges G. Combining all data, an overall effect of 0.36 and 0.32 for DBP and SBP, respectively, was observed (95% CI 0.27-0.44 for DBP and 0.23-0.41 for SBP), with a greater effect being seen for the intervention in crossover trials (DBP 0.47, SBP 0.51). Effect size increased in line with increased dosage. Although not all individual trials showed significance in BP reduction, combining all trials did show a decrease in SBP of 3-4 mm Hg and DBP of 2-3 mm Hg, which further increased with crossover designed trials and intake >370 mg/day. To conclude, magnesium supplementation appears to achieve a small but clinically significant reduction in BP, an effect worthy of future prospective large randomised trials using solid methodology.
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Affiliation(s)
- L Kass
- School of Life Sciences, University of Hertfordshire, Hatfield, UK.
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Lee S, Park HK, Son SP, Lee CW, Kim IJ, Kim HJ. Effects of oral magnesium supplementation on insulin sensitivity and blood pressure in normo-magnesemic nondiabetic overweight Korean adults. Nutr Metab Cardiovasc Dis 2009; 19:781-788. [PMID: 19359148 DOI: 10.1016/j.numecd.2009.01.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 12/16/2008] [Accepted: 01/09/2009] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Little is known about the effect of magnesium on insulin sensitivity and BP in healthy individuals. Therefore, we investigated whether magnesium could improve insulin sensitivity and blood pressure (BP) in normo-magnesemic nondiabetic overweight adults. METHODS AND RESULTS In a double-blinded, placebo-controlled, randomized trial, a total of 155 participants (BMI > or = 23 kg/m(2)) received either 12.3 mmol (300 mg) of elemental magnesium in the form of magnesium oxide (n=75) or placebo (n=80) each day for 12 weeks, constituting the intent-to-treat population. A repeated-measures ANOVA was used to evaluate the between-group changes in variables during the study. The baseline characteristics between the intervention and control groups were similar. There were no significant differences between the groups in the pattern of change of the homeostasis model assessment insulin resistance index, BP over time during the 12-week study. In subgroup analysis, magnesium supplementation (n=8, 27, and 24, respectively) lowered BP much more than placebo (n=16, 29, and 25, respectively) in those subjects whose systolic BP > or = 140 mmHg, diastolic BP 80-90 mmHg, and diastolic BP > or = 90 mmHg at the start of the study (P=0.016, 0.043, and 0.023, respectively); in comparison, those subjects whose initial BP reading was low at baseline did not show a change in BP. No significant adverse events related to magnesium supplementation were recorded. CONCLUSIONS These results suggested that magnesium supplementation does not reduce BP and enhance insulin sensitivity in normo-magnesemic nondiabetic overweight people. However, it appears that magnesium supplementation may lower BP in healthy adults with higher BP.
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Affiliation(s)
- S Lee
- Center for Obesity, Nutrition and Metabolism, Department of Family Medicine, Pusan National University Hospital, 1-10 Ami-dong, Seo-gu, Busan 602 739, South Korea.
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Ohira T, Peacock JM, Iso H, Chambless LE, Rosamond WD, Folsom AR. Serum and dietary magnesium and risk of ischemic stroke: the Atherosclerosis Risk in Communities Study. Am J Epidemiol 2009; 169:1437-44. [PMID: 19372211 DOI: 10.1093/aje/kwp071] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The authors sought to examine the relation between serum or dietary magnesium and the incidence of ischemic stroke among blacks and whites. Between 1987 and 1989, 14,221 men and women aged 45-64 years took part in the first examination of the Atherosclerosis Risk in Communities Study cohort. The incidence of stroke was ascertained from hospital records. Higher serum magnesium levels were associated with lower prevalence of hypertension and diabetes mellitus at baseline. During the 15-year follow-up, 577 ischemic strokes occurred. Serum magnesium was inversely associated with ischemic stroke incidence. The age-, sex-, and race-adjusted rate ratios of ischemic stroke for those with serum magnesium levels of <or=1.5, 1.6, 1.7, and >or=1.8 mEq/L were 1.0, 0.78 (95% confidence interval (CI): 0.62, 0.96), 0.70 (95% CI: 0.56, 0.88), and 0.75 (95% CI: 0.59, 0.95) (P(trend) = 0.005). After adjustment for hypertension and diabetes, the rate ratios were attenuated to nonsignificant levels. Dietary magnesium intake was marginally inversely associated with the incidence of ischemic stroke (P(trend) = 0.09). Low serum magnesium levels could be associated with increased risk of ischemic stroke, in part, via effects on hypertension and diabetes.
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Affiliation(s)
- Tetsuya Ohira
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota 55454-1015, USA
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Abstract
Disorders of mineral metabolism are common in both the office and hospital setting. The diagnosis can be simplified by remembering the target organs involved--intestine, kidney, and bone--and by assessing the presence of kidney disease, levels of parathyroid hormone, and vitamin D status. Although the list of possible causes for these derangements is long, most patients who have hypercalcemia have hyperparathyroidism or malignancy; those who have hypocalcemia, hypophosphatemia, and hypomagnesemia have reduced gastrointestinal absorption, and those who have hyperphosphatemia and hypermagnesemia have increased intake in the setting of kidney disease.
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Affiliation(s)
- Sharon M Moe
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, 1001 West 10th Street, OPW 526, Indianapolis, IN 46202, USA.
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Champagne CM. Magnesium in Hypertension, Cardiovascular Disease, Metabolic Syndrome, and Other Conditions: A Review. Nutr Clin Pract 2008; 23:142-51. [DOI: 10.1177/0884533608314533] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Pripp AH. Effect of peptides derived from food proteins on blood pressure: a meta-analysis of randomized controlled trials. Food Nutr Res 2008; 52:1641. [PMID: 19109662 PMCID: PMC2596738 DOI: 10.3402/fnr.v52i0.1641] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 09/28/2007] [Accepted: 10/20/2007] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In clinical trials, peptides derived from food proteins have shown an effect on blood pressure. This biological mechanism is mainly due to inhibition of angiotensin-I-converting enzyme (ACE), thereby regulating blood pressure through the renin-angiotensin system. A meta-analysis of these trials is needed to better quantify their effect, sources of variation, and possible publication bias. OBJECTIVE To perform a meta-analysis of placebo-controlled clinical trials on peptides derived from food proteins and their effect on blood pressure. DESIGN Trials identified using a defined search strategy in PubMed were included in the meta-analysis, and their pooled effect was estimated with a random effects model. RESULTS Pooled effect of peptides was -5.13 mmHg (95% CI: -7.12, -3.14) for systolic blood pressure, and -2.42 mmHg (95% CI: -3.82, -1.03) for diastolic blood pressure. There were indications of publication bias for diastolic blood pressure data. CONCLUSIONS Peptides derived from food proteins may lead to significantly reduced blood pressure and could therefore be a supplement or alternative to pharmaceutical treatment for mild hypertension. Their effect seems more pronounced, or at least comparable, to that of other food components studied by randomized controlled trials. A high proportion of the reported trials was carried out using the well-known ACE inhibiting tripeptides - Valine-Proline-Proline (VPP) and Isoleucine-Proline-Proline (IPP).
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Affiliation(s)
- Are Hugo Pripp
- Research Services Department, Rikshospitalet, Oslo, Norway
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Beyer FR, Dickinson HO, Nicolson DJ, Ford GA, Mason J. Combined calcium, magnesium and potassium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev 2006:CD004805. [PMID: 16856060 DOI: 10.1002/14651858.cd004805.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Previous research suggests that increasing dietary intakes of calcium, potassium or magnesium separately may reduce BP to a small degree over the short term. It is unclear whether increasing intakes of a combination of these minerals produces a larger reduction in BP. OBJECTIVES To evaluate the effects of combined mineral supplementation as a treatment for primary hypertension in adults. SEARCH STRATEGY We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials, CAB abstracts, and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review. The search was unrestricted by language or publication status. SELECTION CRITERIA Inclusion criteria were: 1) RCTs of a parallel or crossover design comparing oral supplements comprising a combination of potassium, and/or calcium, and/or magnesium with placebo, no treatment, or usual care; 2) treatment and follow-up >=8 weeks; 3) participants over 18 years old, with raised systolic blood pressure (SBP) >=140 mmHg or diastolic blood pressure (DBP) >=85 mmHg with no known primary cause; 4) SBP and DBP reported at end of follow-up. We excluded trials where participants were pregnant, or received antihypertensive medication which changed during the study. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted. MAIN RESULTS We included three RCTs (n=277) with between 24 and 28 weeks follow-up. Three combinations of minerals were investigated: potassium & magnesium, calcium & magnesium, and calcium & potassium. One trial investigated combinations of calcium & magnesium and of calcium & potassium, and for each found a statistically non-significant increase in both SBP and DBP. All three trials investigated the combination of potassium & magnesium. None of the trials provided data on mortality or morbidity. The combination of potassium & magnesium compared to control resulted in statistically non-significant reductions in both SBP (mean difference = -4.6 mmHg, 95% CI: -9.9 to 0.7) and DBP (mean difference = -3.8 mmHg, 95% CI: -9.5 to 1.8), although the results were heterogeneous (I(2)=68% and 85% for SBP and DBP respectively).A sensitivity analysis using alternative reported values which accounted for missing data had very little effect on DBP but resulted in a larger, statistically significant reduction in SBP (mean difference = -5.8 mmHg, 95% CI: -10.5 to -1.0). The quality of the trials was not well reported. AUTHORS' CONCLUSIONS We found no robust evidence that supplements of any combination of potassium, magnesium or calcium reduce mortality, morbidity or BP in adults. More trials are needed to investigate whether the combination of potassium & magnesium is effective.
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Affiliation(s)
- F R Beyer
- University of Newcastle, Centre for Health Services Research, 21 Claremont Place, Newcastle upon Tyne,Tyne & Wear, UK NE2 4AA.
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