Hausberg M1, Kisters K2

1 Department of Medicine I, Karlsruhe General Hospital, Karlsruhe, Germany
2 Department of Medicine I, St.-Anna Hospital, Herne, Germany

There are equivocal data on the influence of magnesium deficiency and supplementation on the cardiovascular system. In
vitro studies demonstrate that magnesium improves parameters of oxidative stress. Also markers of inflammation and
insulin signaling pathways are influenced in a positive way resulting in improved insulin sensitivity. These studies support
the concept of improved endothelial function by magnesium supplementation. Also in-vivo animal studies overall
demonstrate improved endothelial function after magnesium supplemantation with some equivocal findings in different
studies. In-vivo human studies show improved parameters of endothelial function after magnesium supplementation. In
patients with chronic kidney disease magnesium deficiency is associated with increased cardiovascular risk, and
magnesium supplementation in these patients may improve large artery functional and structural properties. However,
the effects of magnesium on lipids, glucose metabolism and other cardiovascular risk factors are judged equivocally. To
this date the limited available prospective randomized studies on dietary magnesium supplementation failed to show an
unequivocally significant effect on cardiovascular event rate in humans. However in some studies and some subgroups
such an effect was observed. Moreover, there seems to be a dose-effect relationship between the dose of magnesium
supplementation and the degree of cardiovascular event reduction. To date, in most observations only low to moderate
doses of magnesium were studied. Further large-scale randomized prospective studies with high dose magnesium
supplementation (i.e. 600 mg per day and more) are warranted.