SERUM MAGNESIUM LEVELS IN HYPERTENSIVE PATIENTS: CORRELATION WITH BLOOD PRESSURE SEVERITY
Main Article Content
Keywords
Serum magnesium, hypertension, blood pressure severity, hypomagnesemia, cardiovascular risk factors
Abstract
Hypertension remains a major global health challenge, with magnesium deficiency emerging as a significant modifiable risk factor. Magnesium influences blood pressure through multiple mechanisms including calcium channel antagonism and nitric oxide production. This study aimed to evaluate serum magnesium levels in hypertensive patients and assess their correlation with blood pressure severity.
Methods: A cross-sectional observational study was conducted at Autonomous State Medical College, Sonebhadra, Uttar Pradesh, from November 2024 to May 2025. A total of 150 patients with essential hypertension were enrolled through consecutive sampling. Participants were classified into Stage 1 and Stage 2 hypertension based on JNC 7 criteria. Serum magnesium levels were estimated using the calmagite dye-binding method. Blood pressure was measured using standardized protocols. Statistical analysis included Pearson's correlation, independent t-test, chi-square test, and multiple linear regression.
Results: The mean age of participants was 54.3±10.8 years with male predominance (58.0%). Stage 2 hypertensive patients had significantly lower serum magnesium levels (1.64±0.38 mg/dL) compared to Stage 1 (1.92±0.34 mg/dL, p<0.001). Overall prevalence of hypomagnesemia was 40.0%, significantly higher in Stage 2 (52.9%) versus Stage 1 (29.3%, p=0.002). Serum magnesium showed moderate negative correlation with systolic blood pressure (r=-0.542, p<0.001) and diastolic blood pressure (r=-0.486, p<0.001). Multiple regression analysis revealed serum magnesium as an independent predictor of systolic blood pressure (β=-0.412, p<0.001).
Conclusion: Serum magnesium levels are inversely correlated with hypertension severity. The high prevalence of hypomagnesemia in hypertensive patients, particularly those with Stage 2 hypertension, suggests the need for routine magnesium screening and consideration of magnesium supplementation in comprehensive hypertension management.
References
• Chidambaram, N., Sethupathy, S., Saravanan, N., Srinivasan, S., Sundram, K., Tanaka, H., & Arunoda, R. (2021). Relationship of sodium and magnesium intakes to hypertension proven by 24-hour urinalysis in a South Indian population. Journal of Clinical Hypertension, 23(4), 678-687. https://doi.org/10.1111/jch.14194
• Correa, S., Guerra-Torres, X. E., Waikar, S. S., Mc Causland, F. R., Powe, N. R., Estrella, M. M., Anderson, A. H., Chen, J., Gadegbeku, C. A., Jamerson, K. A., Kusek, J. W., Ojo, A. O., Shafi, T., Townsend, R. R., Feldman, H. I., & Wolf, M. (2021). Serum magnesium, blood pressure, and risk of hypertension and chronic kidney disease progression in the CRIC study. Hypertension, 78(6), 1771-1780. https://doi.org/10.1161/HYPERTENSIONAHA.121.17694
• Dominguez, L., Veronese, N., & Barbagallo, M. (2020). Magnesium and hypertension in old age. Nutrients, 13(1), 139. https://doi.org/10.3390/nu13010139
• Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in prevention and therapy. Nutrients, 7(9), 8199-8226. https://doi.org/10.3390/nu7095388
• Guerrero-Romero, F., Tamez-Perez, H. E., González-González, G., Salinas-Martínez, A. M., Montes-Villarreal, J., Treviño-Ortiz, J. H., & Rodríguez-Morán, M. (2009). The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: A randomized, double-blind, placebo-controlled clinical trial. Journal of Human Hypertension, 23(4), 245-251. https://doi.org/10.1038/jhh.2008.129
• Gupta, R., Gupta, A., Agrawal, D. P., Agrawal, N. K., Garg, G., & Sarna, M. (2012). Is hypomagnesaemia a coronary risk factor among Indians with coronary artery disease? Journal of Association of Physicians of India, 60, 27-31. PMID: 23447397
• Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2015). Obesity-induced hypertension: Interaction of neurohumoral and renal mechanisms. Circulation Research, 116(6), 991-1006. https://doi.org/10.1161/CIRCRESAHA.116.305697
• Han, H., Fang, X., Wei, X., Liu, Y., Jin, Z., Chen, Q., Fan, Z., Aaseth, J., Hiyoshi, A., He, J., & Cao, Y. (2017). Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: A systematic review and meta-analysis of prospective cohort studies. Nutrition Journal, 16(1), 26. https://doi.org/10.1186/s12937-017-0247-4
• Hatzistavri, L. S., Sarafidis, P. A., Georgianos, P. I., Tziolas, I. M., Aroditis, C. P., Zebekakis, P. E., Pikilidou, M. I., & Lasaridis, A. N. (2009). Oral magnesium supplementation reduces ambulatory blood pressure in patients with mild hypertension. American Journal of Hypertension, 22(10), 1070-1075. https://doi.org/10.1038/ajh.2009.126
• Houston, M. (2011). The role of magnesium in hypertension and cardiovascular disease. Journal of Clinical Hypertension, 13(11), 843-847. https://doi.org/10.1111/j.1751-7176.2011.00538.x
• Khan, A. M., Lubitz, S. A., Sullivan, L. M., Sun, J. X., Levy, D., Vasan, R. S., Magnani, J. W., Ellinor, P. T., Benjamin, E. J., & Wang, T. J. (2010). Lack of association between serum magnesium and the risks of hypertension and cardiovascular disease. American Heart Journal, 160(4), 715-720. https://doi.org/10.1016/j.ahj.2010.06.036
• Ma, J., Folsom, A. R., Melnick, S. L., Eckfeldt, J. H., Sharrett, A. R., Nabulsi, A. A., Hutchinson, R. G., & Metcalf, P. A. (1995). Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: The ARIC study. Journal of Clinical Epidemiology, 48(7), 927-940. https://doi.org/10.1016/0895-4356(94)00200-a
• Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237. https://doi.org/10.1038/s41581-019-0244-2
• Paolisso, G., & Barbagallo, M. (1997). Hypertension, diabetes mellitus, and insulin resistance: The role of intracellular magnesium. American Journal of Hypertension, 10(3), 346-355. https://doi.org/10.1016/s0895-7061(96)00342-1
• Resnick, L. M., Altura, B. T., Gupta, R. K., Laragh, J. H., Alderman, M. H., & Altura, B. M. (1993). Intracellular and extracellular magnesium depletion in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia, 36(8), 767-770. https://doi.org/10.1007/BF00401150
• Rosanoff, A., Costello, R. B., & Johnson, G. H. (2021). Effectively prescribing oral magnesium therapy for hypertension: A categorized systematic review of 49 clinical trials. Nutrients, 13(1), 195. https://doi.org/10.3390/nu13010195
• Singh, R. B., Beegom, R., Rastogi, S. S., Gaoli, Z., & Shoumin, Z. (1997). Epidemiological study of magnesium status and risk of hypertension in a rural population of north India. Magnesium Research, 10(4), 313-320. PMID: 9140862
• Song, Y., Sesso, H. D., Manson, J. E., Cook, N. R., Buring, J. E., & Liu, S. (2006). Dietary magnesium intake and risk of incident hypertension among middle-aged and older US women in a 10-year follow-up study. American Journal of Cardiology, 98(12), 1616-1621. https://doi.org/10.1016/j.amjcard.2006.07.040
• Touyz, R. M. (2007). Role of magnesium in hypertension. Archives des Maladies du Coeur et des Vaisseaux, 100(3), 240-247. PMID: 16762312
• Touyz, R. M. (2012). Magnesium and vascular changes in hypertension. International Journal of Hypertension, 2012, Article ID 754250. https://doi.org/10.1155/2012/754250
• Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., ... Wright, J. T. (2018). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127-e248. https://doi.org/10.1016/j.jacc.2017.11.006
• Zhang, X., Li, Y., Del Gobbo, L. C., Rosanoff, A., Wang, J., Zhang, W., & Song, Y. (2016). Effects of magnesium supplementation on blood pressure: A meta-analysis of randomized double-blind placebo-controlled trials. Hypertension, 68(2), 324-333. https://doi.org/10.1161/HYPERTENSIONAHA.116.07664
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr. Apurva Jha
Assistant Professor, Department of Biochemistry, Autonomous State Medical College, Sonebhadra, Uttar Pradesh, India
Dr. Nikhil Rajak
Assistant Professor, Department of Biochemistry, R D Gardi Medical College, Ujjain, Madhya Pradesh, India
Dr. Prasad Khodke
Assistant Professor, Department of Biochemistry, Nootan Medical College and Research Center, Sankalchand Patel University, Visnagar, Gujarat, India
