Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015

Diet and risk of atrial fibrillation: a systematic review

Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia. Comprehensive modification of established AF risk factors combined with dietary interventions and breaking deleterious habits has been shown to reduce AF burden and recurrence. Numerous AF risk factors, such as diabetes, obesity or hypertension can be partially related to dietary and lifestyle choices. Therefore, dietary interventions may have potential as a therapeutic approach in AF. Based on available data, current guidelines recommend alcohol abstinence or reduction to decrease AF symptoms, burden, and progression, and do not indicate the need for caffeine abstention to prevent AF episodes (unless it is a trigger for AF symptoms). Uncertainty persists regarding harms or benefits of other dietary factors including chocolate, fish, salt, polyunsaturated and monounsaturated fatty acids, vitamins, and micronutrients. This article provides a systematic review of the association between AF and both dietary patterns and components. Additionally, it discusses potentially related mechanisms and introduces different strategies to assess patients' nutrition patterns, including mobile health solutions and diet indices. Finally, it highlights the gaps in knowledge requiring future investigation.

Perspectives on environment and health research in Denmark

AIMS

We provide an overview of nationwide environmental data available for Denmark and its linkage potentials to individual-level records with the aim of promoting research on the potential impact of the local surrounding environment on human health.

BACKGROUND

Researchers in Denmark have unique opportunities for conducting large population-based studies treating the entire Danish population as one big, open and dynamic cohort based on nationally complete population and health registries. So far, most research in this area has utilised individual- and family-level information to study the clustering of disease in families, comorbidities, risk of, and prognosis after, disease onset, and social gradients in disease risk. Linking environmental data in time and space to individuals enables novel possibilities for studying the health effects of the social, built and physical environment.

METHODS

We describe the possible linkage between individuals and their local surrounding environment to establish the exposome - that is, the total environmental exposure of an individual over their life course.

CONCLUSIONS

The currently available nationwide longitudinal environmental data in Denmark constitutes a valuable and globally rare asset that can help explore the impact of the exposome on human health.

Magnesium Administration in Chronic Kidney Disease

Awareness of the clinical relevance of magnesium in medicine has increased over the last years, especially for people with chronic kidney disease (CKD), due to magnesium's role in vascular calcification and mineral metabolism. The inverse association between serum magnesium and clinically relevant, adverse outcomes is well-established in people with CKD. Subsequent intervention studies have focused on the effect of magnesium administration, mainly in relation to cardiovascular diseases, mineral bone metabolism, and other metabolic parameters. The most commonly used routes of magnesium administration are orally and by increasing dialysate magnesium. Several oral magnesium formulations are available and the daily dosage of elemental magnesium varies highly between studies, causing considerable heterogeneity. Although data are still limited, several clinical studies demonstrated that magnesium administration could improve parameters of vascular function and calcification and mineral metabolism in people with CKD. Current clinical research has shown that magnesium administration in people with CKD is safe, without concerns for severe hypermagnesemia or negative interference with bone metabolism. It should be noted that there are several ongoing magnesium intervention studies that will contribute to the increasing knowledge on the potential of magnesium administration in people with CKD.

Comparison of Serum Selenium Levels Between Patients with Newly Diagnosed Atrial Fibrillation and Normal Controls

Atrial fibrillation (AF) is the most common sustained dysrhythmia in the elderly population. It is estimated to affect more than 30 million people worldwide. AF occurs when abnormal electrical impulses start to activate in the atria and override the heart's natural pacemaker, which can no longer control the heart's rhythm. Since atrial contractility is impaired in AF, blood flow in the atria becomes stasis over time and causes thrombus formation. This thrombus causes the risk of embolism and causes complications such as stroke. Therefore, it is a fundamental cause of cardiovascular mortality and morbidity. The diagnosis of AF is usually made with the help of electrocardiography (ECG). The absence of P waves in ECG and irregular R-R interval is sufficient for diagnosis. AF is most commonly associated with advanced age, hypertension, diabetes mellitus, thyroid dysfunction, obesity, alcohol use, physical inactivity, and underlying ischemic heart diseases. As well as to all these usual risk factors, electrolyte disorders and mineral deficiencies also play an essential role in the etiology of AF. Previous studies have clearly demonstrated that serum electrolyte changes have a role in the etiology of AF. These include electrolytes such as serum magnesium, calcium, potassium, and chloride. However, there is not enough information in the literature about the effects of trace elements on AF. Selenium is a trace element that plays an important role in many systems in the human body. It has a vital role in inflammation, regulation of antioxidant reactions, and fibrosis of tissues in both animals and humans. It is known that selenium deficiency causes many cardiovascular diseases such as heart failure, coronary artery disease, and arrhythmia. Our study aimed to compare serum selenium levels in newly diagnosed AF patients with the healthy control group.

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

INTRODUCTION

Cardiovascular diseases are globally a major cause of death. Magnesium deficiency is associated with several diseases including cardiovascular diseases.

OBJECTIVE

To examine if a low concentration of magnesium in drinking water is associated with increased cardiovascular mortality and mortality due to acute myocardial infarction and stroke.

METHODS

A nationwide population-based cohort study using national health registries was used. A total of 4,274,132 individuals aged 30 years or more were included. Magnesium concentration in drinking water was estimated by linkage of residential addresses in the period 2005-2016 with the national drinking water quality monitoring database. The association between magnesium concentration in drinking water and cardiovascular mortality and mortality due to acute myocardial infarction and stroke was examined using a Poisson regression of number of deaths and logarithmic transformation of follow-up time as offset. The incidence rate ratio (IRR) was adjusted for differences in age, sex, calendar year, cohabitation, country of origin, and socioeconomic status.

RESULTS

Median magnesium concentration in drinking water at inclusion was 12.4 mg/L (range: 1.37-54.2 mg/L). The adjusted IRR for cardiovascular mortality was 0.96 (95% CI: 0.94; 0.97) for the lowest magnesium quintile (<6.5 mg/L) as compared to the highest magnesium quintile (>21.9 mg/L). The adjusted IRR for mortality due to acute myocardial infarction and stroke was 1.22 (1.17; 1.27) and 0.96 (0.93; 0.99), respectively, for the lowest magnesium quintile as compared to the highest quintile A decreasing mortality due to acute myocardial infarction was seen with an increasing magnesium concentration in a dose-response manner.

CONCLUSION

Low concentrations of magnesium in drinking water were associated with an increased mortality due to acute myocardial infarction. Low concentrations of magnesium in drinking water were associated with decreased cardiovascular mortality, and mortality due to stroke.