Urinary and plasma magnesium and risk of ischemic heart disease

• Published in: The American journal of clinical nutrition Vol. 97; no. 6; pp. 1299 - 1306
• Main Authors: Joosten, Michel M, Gansevoort, Ron T, Mukamal, Kenneth J, van der Harst, Pim, Geleijnse, Johanna M, Feskens, Edith JM, Navis, Gerjan, Bakker, Stephan JL
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.06.2013; American Society for Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: Adult; adults; Aged; atherosclerosis risk; Biological and medical sciences; blood-pressure; Cardiology. Vascular system; Cardiovascular disease; clinical nutrition; cohort studies; Coronary Artery Disease - drug therapy; Coronary Artery Disease - epidemiology; Coronary Artery Disease - prevention & control; Coronary heart disease; coronary-arteries; Correlation analysis; Diet; diet study techniques; dietary magnesium; disease prevention; endothelial dysfunction; excretion; Feeding. Feeding behavior; Female; Follow-Up Studies; food intake; Fundamental and applied biological sciences. Psychology; Heart; Humans; Incidence; Magnesium; Magnesium - administration & dosage; Magnesium - blood; Magnesium - urine; Male; Medical sciences; men; metabolic syndrome; Middle Aged; mortality; Multivariate Analysis; myocardial ischemia; Myocardial Ischemia - drug therapy; Myocardial Ischemia - epidemiology; Myocardial Ischemia - prevention & control; Myocarditis. Cardiomyopathies; national sample; Nutrition; Plasma; Prospective Studies; risk; Risk assessment; Risk Factors; serum magnesium; sudden-death; Surveys and Questionnaires; systemic inflammation; urine; Vertebrates: anatomy and physiology, studies on body, several organs or systems; women; Micronutrient; Vascular disease; Urine; Biological fluid; Risk factor; Cardiovascular disease; Myocardial ischemia; Risk; Magnesium; Coronary heart disease; Inorganic element; Myocardial disease
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.112.054114

Background: Previous studies on dietary magnesium and risk of ischemic heart disease (IHD) have yielded inconsistent results, in part because of a lack of direct measures of actual magnesium uptake. Urinary excretion of magnesium, an indicator of dietary magnesium uptake, might provide more consistent results.Objective: The objective was to investigate whether urinary magnesium excretion and plasma magnesium are associated with IHD risk.Design: We examined 7664 adult participants free of known cardiovascular disease in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study—a prospective population-based cohort study. Urinary magnesium excretion was measured in 2 baseline 24-h urine collections.Results: Mean ± SD urinary magnesium excretion was 4.24 ± 1.65 mmol/24 h for men and 3.54 ± 1.40 mmol/24 h for women. During a median follow-up of 10.5 y (IQR: 9.9–10.8 y), 462 fatal and nonfatal IHD events occurred. After multivariable adjustment, urinary magnesium excretion had a nonlinear relation with IHD risk (P-curvature = 0.01). The lowest sex-specific quintile (men: <2.93 mmol/24 h; women: <2.45 mmol/24 h) had an increased risk of fatal and nonfatal IHD (multivariable HR: 1.60; 95% CI: 1.28, 2.00) compared with the upper 4 quintiles of urinary magnesium excretion. A similar increase in risk of the lowest quintile was observed for mortality related to IHD (HR: 1.70; 95% CI: 1.10, 2.61). No associations were observed between circulating magnesium and risk of IHD.Conclusions: Low urinary magnesium excretion was independently associated with a higher risk of IHD incidence. An increased dietary intake of magnesium, particularly in those with the lowest urinary magnesium, could reduce the risk of IHD.