Clinical correlates of the molecular and cellular actions of magnesium on the cardiovascular system

Magnesium is a ubiquitous element that participates in metabolic processes essential for life. Magnesium acts as a metallic cofactor in more than 300 enzymatic reactions; notably it is essential for all reactions requiring ATP. Magnesium also functions as a transmembrane and intracellular modulator of other ions. Altered magnesium homeostasis, particularly a deficiency, can cause alterations in metabolic functions that result in clinically recognizable events. Recognition of magnesium deficiency is problematic, since there is no test that will reliably and consistently detect this condition. A high index of suspicion for magnesium deficiency is necessary and treatment should be given when indicated. This article reviews the molecular and cellular actions of magnesium and correlates these basic scientific findings with clinically recognized cardiovascular events in humans. In addition, management guidelines are delineated.