The Role of Magnesium in the Development of Cardiovascular Diseases and the Possibility of their Prevention and Correction with Magnesium Preparations (Part 1)
https://doi.org/10.20996/1819-6446-2019-15-5-725-735
Abstract
The article is devoted to the influence of magnesium on the homeostasis of the body and, in particular, on the cardiovascular system. It describes the importance of the presence and effects of magnesium on various key processes and functions occurring in the body. The reasons for the lack of magnesium and ways to replenish it both in the natural way (eating, certain foods) and magnesium preparations are considered. The article provides examples of large randomized studies that prove the importance of the influence of normal magnesium levels on human health in general and on the state of the cardiovascular system. These studies show how magnesium deficiency increases the risk of cardiovascular diseases and how it can be reduced. It is also shown which trace elements and vitamins are closely related to magnesium metabolism, and how they (in particular, potassium and vitamin B6) improve and facilitate the normalization of magnesium levels. It is noted how comorbidity decreases with the normalization of magnesium level – the higher the magnesium level in the blood plasma (closer to the upper limit and more), the less comorbidity and longer life expectancy. Magnesium is an absolutely essential ion and a good medicine. Magnesium deficiency and hypomagnesemia are quite common, difficult to diagnose (due to underestimation and rare level control) and accompany many diseases of the cardiovascular system and beyond. The widespread use of organic magnesium salts would improve the situation as a whole, due to their universal multiple effect on many processes in the body. This is an integral part of therapeutic and preventive measures in patients with already existing diseases and in people who do not have diseases, but who are at risk due to existing hypomagnesemia.
About the Authors
A. S. Safaryan
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Leading Researcher, Department of Metabolic Disorders Prevention,
Petroverigsky per. 10, Moscow, 101990
V. S. Sargsyan
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Department of Metabolic Disorders Prevention,
Petroverigsky per. 10, Moscow, 101990
T. V. Kamyshova
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Department of Metabolic Disorders Prevention,
Petroverigsky per. 10, Moscow, 101990
N. M. Akhmedzhanov
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Leading Researcher, Department of Metabolic Disorders Prevention,
Petroverigsky per. 10, Moscow, 101990
D. V. Nebieridze
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Professor, Head of Department of Metabolic Disorders Prevention,
Petroverigsky per. 10, Moscow, 101990
E. A. Poddubskaya
National Medical Research Center for Preventive Medicine
Russian Federation
Russian Federation
MD, PhD, Head of Scientific and Organizational Department,
Petroverigsky per. 10, Moscow, 101990
References
1. Kudrin A.V., Gromova O. A. Trace elements in neurology. Moscow: GEOTAR-Media; 2006 (In Russ.)
2. White R.E., Hurtle H.C. Magnesium ions in cardiac function: Regulator of ion channels and second messengers. Biochem Pharmacol. 1989;38: 859-67. DOI:10.1016/0006-2952(89)90272-4.
3. Shkolnikova M. A. magnesium Metabolism and therapeutic value of its preparations. Manual for doctors. Moscow: Medpractika; 2002 (In Russ.)
4. Altura В.М. Basic biochemistry and physiology of magnesium: a brief review. Magnesium Trace Element. 1991;10:167-71.
5. Khaletskaya O.V., Troshin V.M. Minimal brain dysfunction in childhood: a handbook for medical students and doctors. Nizhny Novgorod: NGMA; 1995 (In Russ.)
6. Yulish E.I. The role of magnesium in health and disease. Child health. 2007;5(8):1-5. (In Russ.)
7. Troshin I.Y., Gromova O.A. Magnesium and pyridoxine: fundamental studies and clinical practice. New York: Nova Science Publishers Inc.; 2009.
8. Lynn E.G., Vazhappilly R., Au-Yeung K.K., et al. Magnesium tanshinoate B (MTB) inhibits low density lipoprotein oxidation. Life Sci. 2001;68(8):903-12. DOI:10.1016/s0024-3205(00)00989-9.
9. Gromova O.A., Troshin I.Y. Magnesium and “diseases of civilization”: practical guide. Moscow: GEOTAR-Media;2018 (In Russ.)
10. Gromova O.A., Kalacheva A.G., Troshin I.Y., et al. Deficiency of magnesium - a significant risk factor for the manifestations of comorbid conditions: results of a large-scale screening of magnesium status in the regions of Russia. Pharmateca. 2013;6:116-29 (In Russ.)
11. Troshin I.Y., Gromova O.A. Magnesium: fundamental studies and clinical practice. New York: Nova Biomedical Publishers; 2011.
12. Gromova O.A., Troshin I.Y., Kalacheva A.G., Gromov A.N. Clinical and epidemiological studies of coronary heart disease: magnesium deficiency. Pharmateca. 2014;18(291):48-59 (In Russ.)
13. Gromova O.A., Troshin I.Y., Rudakov K.V., et al. Systematic analysis of magnesium-dependent mitochondrial proteins. Kardiologiia. 2014;9:86-92 (In Russ.) [
14. Jellinek H., Takacs E. Course of the progression of experimentally induced arteriosclerotic vessel wall changes after treatment with magnesium orotate. Arzneimittelforschung. 2000;50(12):1071-7. DOI:10.1055/s-0031-1300345.
15. Jellinek H., Takacs E. Morphological aspects of the effect of magnesium orotate therapy on changes in the vascular walls induced by cholesterol-rich diet. Orv Hetil. 1997;138(36 Suppl 2):2276-80.
16. Gromova O.A., Troshin I.Y., Sardaryan I.S., et al. Prospects of application of preparations on the basis of magnesium orotate in patients with cardiovascular diseases. Effective Pharmacotherapy. 2013;33:52-63 (In Russ.)
17. Silva A.P., Gundlach K., Büchel J., et al. Low Magnesium Levels and FGF-23 Dysregulation Predict Mitral Valve Calcification as well as Intima Media Thickness in Predialysis Diabetic Patients. Int J Endocrinol. 2015;2015:308190. DOI:10.1155/2015/308190.
18. Guerrero-Romero F., Flores-García A., Saldaña-Guerrero S., et al. Obesity and hypomagnesemia. Eur J Intern Med. 2016;34:29-33. DOI:10.1016/j.ejim.2016.06.015.
19. Barbagallo M., Dominguez L.J. Magnesium and type 2 diabetes. World J Diabetes. 2015;6(10):1152-7. DOI:10.4239/wjd.v6.i10.1152.
20. Thongprayoon C., Cheungpasitporn W., Erickson S.B. Admission hypomagnesemia linked to septic shock in patients with systemic inflammatory response syndrome. Ren Fail. 2015;37 (9):1518-21. DOI:10.3109/0886022X.2015.1074519.
21. Nielsen F.H. Effects of magnesium depletion on inflammation in chronic disease. Curr Opin Clin Nutr Metab Care. 2014;17(6):525-30. DOI:10.1097/MCO.0000000000000093.
22. Cheungpasitporn W., Thongprayoon C., Mao M.A., et al. Hypomagnesaemia linked to depression: a systematic review and meta-analysis. Intern Med J. 2015;45(4):436-40. DOI:10.1111/ imj.12682.
23. Ma J., Folsom A.R., Melnick S.L., et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Atherosclerosis Risk in Communities Study. J Clin Epidemiol. 1995;48(7):927-40. DOI:10.1016/0895-4356(94)00200-a.
24. Misialek J.R., Lopez F.L., Lutsey P.L., et al. Serum and dietary magnesium and incidence of atrial fibrillation in whites and in African Americans - Atherosclerosis Risk in Communities (ARIC) study. Circ J. 2013;77(2):323-9. DOI:10.1253/circj.cj-12-0886.
25. Hruby A., O'Donnell C.J., Jacques P.F., et al. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study. JACC Cardiovasc Imaging. 2014;7(1):59-69. DOI:10.1016/j.jcmg.2013.10.006
26. Chiuve S.E., Korngold E.C., Januzzi J.L. Jr., et al. Plasma and dietary magnesium and risk of sudden cardiac death in women. Am J Clin Nutr. 2011;93(2):253-60. DOI:10.3945/ajcn.110.002253
27. Rosanoff A., Plesset M.R. Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. Magnes Res. 2013;26 (3):93-9. DOI:10.1684/mrh.2013.0343
28. Ferrara L.A., Iannuzzi R., Castaldo A., et al. Long-term magnesium supplementation in essential hypertension. Cardiology. 1992;81:25-33. DOI:10.1159/000175772.
29. Hiraga H., Oshima T., Yoshimura M., et al. Abnormal platelet Ca2+ handling accompanied by increased cytosolic free Mg2+ in essential hypertension. Am J Physiol. 1998;275 (2 pt 2):574-9. DOI:10.1152/ajpregu.1998.275.2.R574.
30. Whelton P.K., Klag M.J. Magnesium and blood pressure: review of the epidemiologic and clinical trial experience. Am J Cardiol. 1989;63:26-30. DOI:10.1016/0002-9149(89)90215-4.
31. Touyz R.M. Role of magnesium in the pathogenesis of hypertension. Mol Aspects Med. 2003; 24: 107-36. DOI:10.1016/S0098-2997(02)00094-8.
32. Elin R.J. Magnesium metabolism in health and disease. In: Bone R.C., ed. Disease-a-Month. Chicago: Year Book Medical Publishers Inc; 1988.
33. Knopf M., Valcin A., Yang T.S., et al. Potassium flux in the heart and its relation to magnesium iron. Bull N Y Acad Med. 1971;47(10):1228.
34. Panhwar A.H., Kazi T.G., Afridi H.I., et al. Distribution of potassium, calcium, magnesium, and sodium levels in biological samples of Pakistani hypertensive patients and control subjects. Clin Lab. 2014;60(3):463-74.
35. Wu X., Ackermann U., Sonnenberg H. Hypertension development in Dahl S and R rats on high saltlow potassium diet: calcium, magnesium and sympathetic nervous system. Clin Exp Hypertens. 1998;20(7):795-815.
36. Touyz R.M., Milne F.J., Seftel H.C., Reinach S.G. Magnesium, calcium, sodium and potassium status in normotensive and hypertensive Johannesburg residents. S Afr Med J. 1987;72(6):377-81.
37. Murata T., Horiuchi T., Goto T., et al. Vasomotor response induced by change of extracellular potassium and magnesium in cerebral penetrating arterioles. Neurosci Res. 2011;70(1):30-4. DOI:10.1016/j.neures.2011.01.017.
38. Gromova O.A., Kalacheva A.G., Troshin I.Y., Grishina T. R., Yudina N.V. Potassium-saving properties of magnesium. Kardiologiia. 2013;10:38-48. (In Russ.)
39. Houston M.C. The importance of potassium in managing hypertension. Curr Hypertens Rep. 2011;13(4):309-17. DOI:10.1007/s11906-011-0197-8.
40. Rebrov V.G., Gromova O.A. Vitamins, macro- and micronutrients. Moscow: Geotar-Med; 2008 (In Russ.)
41. Houston M.C., Harper K.J. Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. J Clin Hypertens (Greenwich). 2008;10(7):3-11.
42. Rimm E.B., Willett W.C., Hu F.B., et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998;279(5):359-64. DOI:10.1001/jama. 279.5.359.
43. Molina-López J., Florea D., Quintero-Osso B., et al. Pyridoxal-5'- phosphate deficiency is associated with hyperhomocysteinemia regardless of antioxidant, thiamine, riboflavin, cobalamine, and folate status in critically ill patients. Clin Nutr. 2016;35(3):706-12. DOI:10.1016/j.clnu.2015.04.022.
44. Liu Z., Li P., Zhao Z.H., et al. Vitamin B6 Prevents Endothelial Dysfunction, Insulin Resistance, and Hepatic Lipid Accumulation in Apoe (-/-) Mice Fed with High-Fat Diet. J Diabetes Res. 2016;2016:1748065. DOI:10.1155/2016/1748065.
45. Ekim M., Ekim H., Yilmaz Y.K., et al. Study on relationships among deep vein thrombosis, homocysteine & related B group vitamins. Pak J Med Sci. 2015;31(2):398-402.
46. Morris M.S., Sakakeeny L., Jacques P.F., et al. Vitamin B-6 intake is inversely related to, and the requirement is affected by, inflammation status. J Nutr. 2010;140(1):103-10. DOI:10.3945/jn.109. 114397.
47. Lumme J.A., Jounela A.J. The effect of potassium and potassium plus magnesium supplementation on ventricular extrasystoles in mild hypertensives treated with hydrochlorothiazide. Int J Cardiol. 1989;25(1):93-7. DOI:10.1016/0167-5273(89)90168-x.
48. Afridi H.I., Kazi T.G., Kazi N., et al. Potassium, calcium, magnesium, and sodium levels in biological samples of Pakistani myocardial infarction patients at different stages as related to controls. Clin Lab. 2010;56(9-10):427-39.
49. Trekova N.A., Andrianova M.I., Tolstova I.A., et al. Use of a potassium and magnesium asparaginate solution to maintain the balance of potassium and magnesium during cardiosurgical interventions under extracorporeal circulation. Anesteziol Reanimatol. 2008;(5):17-21 (In Russ.)
50. Fischer P.W., Giroux A. Effects of dietary magnesium on sodium-potassium pump action in the heart of rats. J Nutr. 1987;117(12):2091-5. DOI:10.1093/jn/117.12.2091.
51. Vester E.G. Clinico-electrophysiologic effects of magnesium, especially in supraventricular tachycardia. Herz. 1997;22 Suppl 1:40-50.
52. Takanaka C., Ogunyankin K.O., Sarma J.S., Singh B.N. Antiarrhythmic and Arrhythmogenic Actions of Varying Levels of Extracellular Magnesium: Possible Cellular Basis for the Differences in the Efficacy of magnesium and Lidocaine in Torsade de Pointes. J Cardiovasc Pharmacol Ther. 1997;2(2):125- 34. DOI:10.1177/107424849700200206.
53. Song L., Yang Y.M., Zhu J. Clinical characteristics of 52 patients with torsade de points associated with acquired QT prolongation. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39(4):293- 6. DOI:10.3760/cma.j.issn.0253-3758.2011.04.002.
54. Pu J., Zhang C., Quan X., et al. Effects of potassium aspartate and magnesium on ventricular arrhythmia in ischemia-reperfusion rabbit heart. J Huazhong Univ Sci Technolog Med Sci. 2008;28(5):517- 9. DOI:10.100.7/s11596-008-0506-x.
55. Gurfinkel E., Pazos A.A., Mautner B. Abnormal QT intervals associated with negative T waves induced by antiarrhythmic drugs are rapidly reduced using magnesium sulfate as an antidote. Clin Cardiol. 1993;16(1):35-8. DOI:10.100.2/clc.4960160108.
56. Bachman D.M. Oral magnesium ion shortens prolonged QTc interval. J Clin Psychiatry. 2003;64(6):733-4. DOI:10.4088/jcp.v64n0618d.
57. Kurita T. Antiarrhythmic effect of parenteral magnesium on ventricular tachycardia associated with long QT syndrome. Magnes Res. 1994;7(2):155-7.
58. Shiga T., Wajima Z., Inoue T., Ogawa R. Magnesium prophylaxis for arrhythmias after cardiac surgery: a meta-analysis of randomized controlled trials. Am J Med. 2004;117(5):325-33. DOI:10.1016/j.amjmed.2004.03.030.
59. Holzgartner H., Maier E., Vierling W. High-dosage oral magnesium therapy in arrhythmias. Results of an observational study in 1.160 patients with arrhythmia. Fortschr Med. 1990;108(28):539- 42.
60. Zhi Y.F., Huang Y.S., Xu B.S., Wang S.R. Clinical investigation of the protective effects of potassium magnesium aspartate against arrhythmia and its possible antioxidative mechanism. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007;19(11):662-6.
61. Kryuchkova, T.A., Barzasekov S.A., Romanova T.A., et al. Clinical application value of Panangin in children with undifferentiated developmental connective tissue diseases. Scientific statements Belgorod state University. Series: Medicine. Pharmacy. 2013;21(4):77-82 (In Russ.)
62. Del Gobbo L.C., Imamura F., Wu J.H., et al. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2013;98(1):160-73. DOI:10.3945/ajcn.112.053132.
63. Zhi Y.F., Huang Y.S., Xu B.S., Wang S.R. Clinical investigation of the protective effects of potassium magnesium aspartate against arrhythmia and its possible anti-oxidative mechanism. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 200;19(11):662-6.
64. Zhu W.L. A multi-center randomized clinical trial to evaluate the efficacy of early administration of magnesium in acute myocardial infarction. Chinese Journal of Cardiology. 2002;30:82-5.
65. Wu G., Tian H., Han K., et al. Potassium magnesium supplementation for four weeks improves small distal artery compliance and reduces blood pressure in patients with essential hypertension. Clin Exp Hypertens. 2006;28(5):489-97. DOI:10.1080/10641960600798705.
66. Michon P. Level of total and ionized magnesium fraction based on biochemical analysis of blood and hair and effect of supplemented magnesium (Slow Mag B6) on selected parameters in hypertension of patients treated with various groups of drugs. Ann Acad Med Stetin. 2002;48:85-97.
67. Rosanoff A. Magnesium supplements may enhance the effect of antihypertensive medications in stage 1 hypertensive subjects. Magnes Res. 2010;23(1):27-40. DOI:10.1684/mrh.2010.0198.
68. Kass L., Weekes J., Carpenter L. Effect of magnesium supplementation on blood pressure: a metaanalysis. Eur J Clin Nutr. 2012;66(4):411-8. DOI:10.1038/ejcn.2012.4.
69. Jee S.H., Miller E.R. 3rd, Guallar E., et al. The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens. 2002;15(8):691-6. DOI:10.1016/s0895-7061(02)02964-3.
70. Wu G., Tian H., Han K., et al. Potassium magnesium supplementation for four weeks improves small distal artery compliance and reduces blood pressure in patients with essential hypertension. Clin Exp Hypertens. 2006;28(5):489-97. DOI:10.1080/10641960600798705.
71. Bullarbo M., Odman N., Nestler A., et al. Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial. Arch Gynecol Obstet. 2013;288(6):1269-74. DOI:10.1007/s00404-013-2900-2.
72. Chacko S.A., Song Y., Nathan L., et al. Relations of dietary magnesium intake to biomarkers of inflammation and endothelial dysfunction in an ethnically diverse cohort of postmenopausal women. Diabetes Care. 2010;33(2):304-10. DOI:10.2337/dc09-1402.
73. de Oliveira Otto M.C., Alonso A., Lee D.H., et al. Dietary micronutrient intakes are associated with markers of inflammation but not with markers of subclinical atherosclerosis. J Nutr. 2011;141(8):1508-15. DOI:10.3945/jn.111.138115.
Review
For citations:
Safaryan A.S., Sargsyan V.S., Kamyshova T.V., Akhmedzhanov N.M., Nebieridze D.V., Poddubskaya E.A. The Role of Magnesium in the Development of Cardiovascular Diseases and the Possibility of their Prevention and Correction with Magnesium Preparations (Part 1). Rational Pharmacotherapy in Cardiology. 2019;15(5):725-735. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-5-725-735
Views: 843
Email this article 