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Angiotensin converting enzyme inhibitors, thiazide diuretics and magnesium balance. A preliminary study
P L Malini1, E Strocchi, G Valtancoli
1Department of Medical Therapeutics, S. Orsola University Hospital, Bologna, Italy.
Insights
Thiazide diuretics deplete magnesium in hypertensive patients, even when serum levels appear normal. This intracellular magnesium depletion is not detected by standard serum tests.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
- Pharmacology
Background:
- Hypertension management often involves diuretics, which can affect electrolyte balance.
- Magnesium plays a crucial role in cardiovascular health and cellular function.
- Assessing intracellular magnesium is important for understanding drug-induced biochemical changes.
Purpose of the Study:
- To investigate the effect of different antihypertensive medications on magnesium levels.
- To determine if thiazide diuretics cause magnesium depletion not reflected in serum levels.
- To compare magnesium content in serum and mononuclear cells across treatment groups.
Main Methods:
- Cross-sectional study involving hypertensive patients on atenolol, enalapril, thiazides, or combination therapy.
- Measurement of serum magnesium and mononuclear cell magnesium content.
- Comparison of magnesium levels between different treatment groups.
Main Results:
- Patients treated with thiazide diuretics alone showed decreased mononuclear cell magnesium.
- Serum magnesium levels remained normal in patients treated with thiazides.
- This suggests thiazides induce intracellular magnesium depletion undetectable by serum monitoring.
Conclusions:
- Thiazide diuretics can lead to significant intracellular magnesium depletion in hypertensive patients.
- Standard serum magnesium monitoring may underestimate the impact of thiazides on body magnesium stores.
- Monitoring intracellular magnesium may be necessary to fully assess the effects of thiazide therapy.
Abstract:
Serum and mononuclear cell magnesium content were determined in a cross-sectional study performed in four groups of hypertensive patients on chronic treatment with atenolol (n = 11), enalapril (n = 10), thiazide diuretics (n = 12), or enalapril + thiazides (n = 11). Our study shows that in patients treated with the thiazides alone, in spite of normal serum potassium and magnesium levels, mononuclear cell magnesium was decreased. To the extent that mononuclear Mg content mirrors the body ion stores, our results indicate that thiazides induce a Mg depletion not detectable by monitoring serum levels.