The Prevalenceof Hypomagnesemiain Essential Hypertensive Patients

SUMMARY Magnesium is the fourth most common cation in the human body, and it plays a critical role in many metabolic processes, including production and use of the energy essential in the maintenance of normal intracellular electrolyte composition. In general, gastrointestinal losses and renal magnesium wasting constitute the major causes of hypomagnesemia. The acquired forms of renal magnesium wasting are largely drug induced. We analyzed serum magnesium levels in ambulatory patients with uncomplicated essential hypertension who are under diuretic or diuretic combination therapy and who are under non-diuretic antihypertensive therapy. We planned to determine hypomagnesemia prevalence in patients on different antihypertensive medications. Serum magnesium levels were determined in 1000 patients attending Antalya Training and Research Hospital, Hypertension Clinic. A total of 456 patients in 2012 and 544 patients in 2013 were enrolled in this study. All patients were on antihypertensive therapy for at least 1 year. Magnesium level below 1.7 mg/dl was considered as hypomagnesemia. The study group included 51.7 % male and 48.3 % female patients and the mean age was 56.20 17.64 years. Because the proton pump inhibitors may cause hypomagnesemia, patients taking these drugs were also recorded and included in study groups. In both groups, there was statistically no significant difference between the number of the hypertensive agents and the frequency of hypomagnesemia (pgreater than0, 05). The chi-squared test found the hypomagnesemia prevalence as 7.1 % in the diuretic group, while it was 6.8 %. The relationship between the development of hypomagnesemia and use of proton pump inhibitors (PPIs) was also evaluated.48 patients (9, 3 %) in diuretic group and 53 patients (10, 8) in the non-diuretic group were using PPIs. When the 2 groups were compared in means of hypomagnesemia development, 8 patients in the diuretic receiving group (16.6 %) and 4 patients in the non-diuretic receiving group (7.54 %) had hypomagnesemia, and the difference was statistically significant (p0, 05). In summary, in ambulatory hypertensive patients which use diuretic and nondiuretic antihypertensive combinations, there was statistically no significant difference in hypomagnesemia frequency. Routine measurement of serum magnesium proved unrewarding in these group of patients. Except in patients receiving high-dose thiazides and loop diuretics, the prevalence of hypomagnesemia may be higher. Serum magnesium determinations might be reserved for selected circumstances, when other factors potentiating magnesium deficiency are present, such as patients with nutritional problems and low dietary intake, gastrointestinal losses, renal losses and PPIs usage. Therefore, in patients with uncomplicated hypertension, if there is no symptom regarded with hypomagnesemia, routine serum magnesium determination seems unnecessary.