Serum Magnesium, Blood Pressure, and Risk of Hypertension and Chronic Kidney Disease Progression in the CRIC Study

Abstract

Magnesium is involved in the regulation of blood pressure (BP). Abnormalities in serum magnesium are common in chronic kidney disease (CKD), yet its association with the development of hypertension and CKD progression in patients with CKD is unclear. We analyzed data from 3866 participants from the CRIC Study (Chronic Renal Insufficiency Cohort). Linear regression assessed the association of serum magnesium with baseline systolic BP (SBP) and diastolic BP (DBP). Logistic regression explored the association of serum magnesium with various definitions of hypertension. Cox proportional hazards models explored assessed the risk of incident hypertension and CKD progression. Mean serum magnesium was 2.0 mEq/L (±0.3 mEq/L). Higher magnesium was associated with lower SBP (−3.4 mm Hg [95% CI, −5.8 to −1.0 per 1 mEq/L]) and lower DBP (−2.9 mm Hg [95% CI, −4.3 to −1.5 per 1 mEq/L]). Higher magnesium was associated with a lower risk of American Heart Association–defined hypertension (SBP≥130 mm Hg or DBP≥80 mm Hg) at baseline (adjusted hazard ratio, 0.65 [95% CI, 0.49–0.86 per 1 mEq/L]), a lower risk of suboptimally controlled BP (SBP≥120 mm Hg or DBP≥80 mm Hg; adjusted odds ratio, 0.58 [95% CI, 0.43–0.78 per 1 mEq/L]). In time-to-event analyses, higher baseline serum magnesium was associated with a nominally lower risk of incident CRIC-defined hypertension (adjusted hazard ratio, 0.77 [95% CI, 0.46–1.31 per 1 mEq/L]). Higher magnesium was associated with a significantly lower risk of CKD progression (adjusted hazard ratio, 0.68 [95% CI, 0.54–0.86 per 1 mEq/L]). In patients with CKD, higher serum magnesium is associated with lower SBP and DBP, and with a lower risk of hypertension and CKD progression. In patients with CKD, whether magnesium supplementation could optimize BP control and prevent disease progression deserves further investigation.

Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients

“…Magnesium plays an important role in the cardiovascular system through its antithrombosis and antiinflammatory effects, as well as the regulation of blood pressure, endothelial cell function, glucose, and insulin metabolism. 6 , 7 Previous observational studies have shown that the serum magnesium was inversely associated with the risk of a wide range of diseases, including cardiovascular disease (CVD), 3 , 8 , 9 type 2 diabetes mellitus, 10 , 11 metabolic syndrome, 12 arterial hypertension, 13 , 14 and chronic kidney disease, 13 , 15 and also associated with coronary heart disease mortality. 16 Based on the pathogenesis of magnesium and CVD, studies found that serum magnesium was associated with stroke risk.…”

Ionized and total magnesium levels in patients with chronic kidney disease: associated factors and outcomes

“…Overall, we found that ionized and tMg were associated with the same factors: age, eGFR, diabetes, BMI, serum calcium, phosphate, albumin, urea and triglycerides, and prescriptions of PPIs, high-ceiling diuretics, potassium chelators and laxatives. These predictors of magnesium concentration have already been described in the literature for tMg levels [ 22 , 24 , 25 , 43 , 44 ]. So, we extended these findings for iMg levels.…”

Magnesium and Zinc Intake Ratio Mediates the Increase of Coronary Artery Calcification through Upregulating Interleukin 6

“…In addition, the protective effects of minerals among CVD patients have become an important and interesting topic for many researchers. Additionally, effects of several minerals on CAC and CAC risk factors such as hypertension, altered serum lipids, peripheral artery disease, and DM have been reported [ 34 , 35 ]. Furthermore, some of these studies have also shown that increased intakes of calcium (Ca), Mg, and potassium (K) have a negative correlation with blood pressure, which is also a strong risk factor for the development and progression of CAC [ 36 , 37 ].…”