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Serum magnesium, calcium, phosphate and PTH following long-term beta-blockade in ischaemic heart disease
H Perrild1, H Jessen-Jürgensen, F Pedersen
1Department of Internal Medicine, Herlev Hospital, Denmark.
Insights
Non-cardioselective beta-blocker alprenolol did not alter serum magnesium or calcium levels in patients with ischemic heart disease over 12 months. This suggests alprenolol is safe for managing these patients without inducing cardiotoxic mineral disturbances.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Biochemistry
Background:
- Ischemic heart disease (IHD) management often involves beta-blockers.
- Concerns exist regarding potential cardiotoxic effects of beta-blockers on serum mineral levels.
- Non-cardioselective beta-blockers like alprenolol require safety evaluation in IHD patients.
Purpose of the Study:
- To investigate the effect of alprenolol on serum magnesium, parathyroid hormone (PTH), phosphate, calcium, and ionized calcium levels in IHD patients.
- To assess the safety profile of alprenolol concerning mineral metabolism in IHD.
- To determine if alprenolol induces cardiotoxic disturbances in serum calcium and magnesium.
Main Methods:
- A randomized controlled trial involving 40 patients with ischemic heart disease.
- Patients were treated with either alprenolol (n=20) or placebo (n=20) for 12 months.
- Serum levels of magnesium, PTH, phosphate, calcium, and ionized calcium were monitored throughout the study and during a 2-week withdrawal period.
Main Results:
- Serum levels of magnesium, PTH, phosphate, calcium, and ionized calcium remained unchanged and within normal limits in both the alprenolol and placebo groups.
- No significant alterations were observed during the 12-month treatment period or the subsequent 2-week withdrawal phase.
- Alprenolol treatment did not induce any cardiotoxic disturbances in the measured serum mineral levels.
Conclusions:
- The non-cardioselective beta-blocker alprenolol can be safely administered to patients with ischemic heart disease.
- Alprenolol does not appear to cause cardiotoxic disturbances in serum magnesium and calcium levels.
- Further research is needed to establish if these findings apply to cardioselective beta-blockers.
Abstract:
In 40 patients with ischaemic heart disease the serum levels of magnesium, parathyroid hormone (PTH), phosphate, calcium, and ionized calcium remained unchanged and within normal limits following treatment for 12 months with alprenolol (n = 20) or placebo (n = 20). No changes occurred during a 2 week withdrawal period. The clinical implication is that the non-cardioselective betablocker alprenolol can be given to patients with ischaemic heart disease without the risk of inducing potentially cardiotoxic disturbances in serum magnesium and serum calcium levels. Whether this applies to cardioselective beta-blockers remains to be established.