Magnesium & Cardiovascular Diseases

Ischemic Heart Disease

Patients with low Mg levels have a higher risk of coronary artery disease. High Mg levels are associated with a reduced cardiovascular disease and mortality. This inverse association between Mg levels and coronary artery disease has been noted both in women and men. Low Mg levels have also been implicated in major adverse events following drug-eluting stent  implantation . Mg levels are frequently low after cardiac surgery and may play a role in the development of post-operative arrhythmias. Hypomagnesemia with Mg <  2 mEq/L or less is also associated with increased mortality in ambulatory heart failure patents. The main pathology in ischemic heart disease is atherosclerosis, and Mg deficiency may exacerbate this process. Epidemiological studies have found a direct correlation between low Mg levels and atherosclerosis. Hypomagnesemia also adversely affects lipid metabolism and C-reactive protein. Both of these abnormalities have deleterious effects on endothelial function, accelerating atherosclerosis. 

Cardiac arrhythmias and sudden cardiac death

Low Mg levels are suspected as being arrhythmogenic. Recent studies have reported a significantly reduced risk of ventricular arrhythmia and sudden cardiac death with elevated serum Mg concentrations. Several reports have implicated hypomagnesemia in serious ventricular arrhythmias – ventricular tachycardia, ventricular fibrillation, and polymorphic ventricular tachycardia ‘torsades de pointes’. Premature ventricular complexes (PVC’s) are predictive of future cardiac events and sudden cardiac death.. Hypo-magnesia is associated with increased PVC’s in a diabetic population. Mg may also help in the treatment of digitalis toxicity related arrhythmias. Intravenous Mg has also been used to treat ventricular tachycardia and is recommended as a first line therapy for tosades de pointes associated with long QT interval  Low Mg intake has also been linked to increased supraventricular arrhythmias, including atrial fibrillation.

Hypertension

Patients with hypertension tend to have lower Mg levels. Epidemiological studies suggest that increased Mg intake is associated with less hypertension. Further, Mg supplementation reduces blood pressure. This has also been confirmed in ambulatory BP monitoring. Mg supplementation can be achieved by using mineral salt substitute. These reductions in BP are partially attributable to a reduction in sodium intake. Mechanisms include alterations sodium and potassium activity, suppression of the adrenergic activity and possible natriuresis. The final result is a reduction in vascular resistance and the blood pressure.

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