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Low serum magnesium concentrations predict cardiovascular and all-cause mortality
Thorsten Reffelmann1, Till Ittermann, Marcus Dörr
1Klinik und Poliklinik für Innere Medizin B, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Friedrich-Löffler Str. 23 a, 17487 Greifswald, Germany. ThorstenReffelmann@web.de
Insights
Low serum magnesium (Mg++) levels are linked to increased all-cause and cardiovascular mortality. This finding highlights magnesium
Area of Science:
- Cardiovascular Epidemiology
- Clinical Biochemistry
- Public Health Research
Background:
- Low serum magnesium (Mg++) is linked to left ventricular hypertrophy, independent of traditional cardiovascular risk factors.
- Left ventricular hypertrophy carries significant prognostic implications for cardiovascular health.
- Previous research in the Study of Health in Pomerania (SHIP) indicated a link between low Mg++ and future left ventricular hypertrophy.
Purpose of the Study:
- To investigate the association between serum magnesium (Mg++) levels and cardiovascular mortality.
- To determine if hypomagnesemia predicts long-term mortality risk.
Main Methods:
- A Cox proportional hazard model was used to analyze mortality in relation to baseline serum Mg++ concentrations.
- The Study of Health in Pomerania (SHIP) cohort (n=4203) was analyzed, excluding subjects on Mg++ supplementation.
- Mortality follow-up was conducted over a median of 10.1 years, accumulating 38,075 person-years.
Main Results:
- Subjects with serum Mg++ ≤0.73 mmol/l exhibited significantly higher all-cause mortality (10.95 vs. 1.45 deaths/1000 person-years) and cardiovascular mortality (3.44 vs. 1.53 deaths/1000 person-years).
- These associations remained statistically significant after adjusting for multiple cardiovascular risk factors, including hypertension and diuretic use.
- Log-rank tests confirmed the significance: p=0.0001 for all-cause mortality and p=0.0174 for cardiovascular mortality.
Conclusions:
- Low serum magnesium (Mg++) levels are significantly associated with increased all-cause and cardiovascular mortality.
- These findings support the hypothesis that hypomagnesemia is a predictor of mortality.
- The results align with previous observations linking hypomagnesemia to increased left ventricular mass over time.
Background:
Low serum magnesium (Mg(++)) levels are associated with future development of left ventricular hypertrophy independently of common cardiovascular risk factors, as recently demonstrated in the five-year follow-up of the population-based Study of Health in Pomerania (SHIP). As left ventricular hypertrophy has significant prognostic implications, we hypothesized that serum Mg(++) levels are associated with cardiovascular mortality.
Method And Results:
All-cause mortality and cardiovascular mortality were analyzed in relationship to serum Mg(++) concentrations at baseline by Cox proportional hazard model in SHIP (n=4203, exclusion of subjects with Mg(++) supplementation). The median duration of mortality follow-up was 10.1 years (25th percentile: 9.4 years, 75th percentile: 10.8 years; 38,075 person-years). During the follow-up, 417 deaths occurred. Mortality in subjects with Mg(++)≤0.73 mmol/l was significantly higher for all-cause deaths (10.95 death per 1000 person years), and cardiovascular deaths (3.44 deaths per 1000 person years) in comparison to higher Mg(++) concentrations (1.45 deaths from all-cause per 1000 person years, 1.53 deaths from cardiovascular cause per 1000 person years). This association remained statistically significant after adjustment for multiple cardiovascular risk factors, including arterial hypertension, and antihypertensive therapy including diuretics (log-rank-test p=0.0001 for all-cause mortality, and p=0.0174 for cardiovascular mortality).
Conclusions:
Low serum Mg(++) levels are associated with higher all-cause mortality and cardiovascular mortality. This corresponds well with recent findings that hypomagnesemia is associated with the increase of left ventricular mass over the following years.
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