Healthy Living

Magnesium for a healthy heart – nature’s superweapon

Magnesium has long been a staple in diets globally around the world. Present in abundance in many foods that we regularly consume. From the ages of 14-18, our magnesium requirement starts to increase significantly. Males generally need about 400mg of magnesium a day, and females need approximately 300mg to meet their recommended daily intake, which increases slightly as you age.

The average adult’s dietary intake of magnesium is adequate from milk to various seeds and nuts. However, the Australian Bureau of Statistics demonstrated that about 1 in 3 Australians don’t get enough magnesium and about 50-60% in those over 70 don’t meet their daily magnesium requirement.

 

So why does magnesium matter?

Magnesium has various effects throughout the body, not just on the cardiovascular system, and is thought to enhance sleep quality [1] and muscle recovery post-exercise. [2] But most importantly, studies have demonstrated magnesium deficiency will increase your risk of developing conditions like diabetes or coronary artery disease, as well as increase your risk for stroke. [3]

Through the many effects explained below, this unassuming mineral is a powerhouse that supports cardiovascular and general health and well-being.

Magnesium for a healthy heart – nature’s superweapon Heart Matters

 

Magnesium and heart health

Magnesium and irregular heart rhythms

Magnesium has been shown, through lab-based and real-world clinical research, to positively affect the prevention of irregular heartbeats, such as atrial fibrillation (AF). Several studies have highlighted the potential link between low serum magnesium levels and the development of AF.

In a subgroup analysis of participants in the Framingham-Offspring study (a continuation of the famous long-running FRAMINGHAM study), low-normal blood magnesium was associated with an increased risk of AF in the community, even after adjusting for blood potassium levels [4], when compared to those with higher levels of magnesium within the “normal” range (0.85-1.10). This suggests that Magnesium plays a key role in preventing atrial fibrillation.

Moreover, the role of magnesium in preventing AF after cardiac surgery has been extensively studied. A study in 2023 found that the proportion of patients with postoperative AF was lower in those who received magnesium, suggesting a potential role of magnesium in preventing AF following cardiac surgeries [5].

The link between magnesium and preventing acute bouts of irregular heart rate remains contentious. However, as we’ll learn, the long-term effects of magnesium on your heart make it more than worth it to keep your levels up.

 

Endothelial Health

Magnesium plays a crucial role in maintaining endothelial function. The endothelium is the microscopic inner lining of all your vessels throughout your body, and a healthy endothelium is central to keeping pathology like plaque and atherosclerosis (causes of coronary artery disease and hypertension) at bay. Endothelial function significantly affects many risk factors for cardiovascular disease, such as hypertension, diabetes or pre-diabetes, and disorders of cholesterol metabolism [6].

Studies have shown that magnesium supplementation in those with stable coronary artery disease can help improve exercise tolerance and blood flow versus placebo. [7]

 

Heart Remodelling

In addition to its effects on endothelial function, magnesium influences heart remodelling processes. It helps regulate the balance between cardiac muscle contraction and relaxation, critical for maintaining optimal heart function, particularly for those at risk of developing heart failure. [8]

 

Anti-inflammatory Effects

Magnesium exhibits anti-inflammatory properties, which are beneficial for heart health. Chronic inflammation is a crucial driver of cardiovascular diseases, including atherosclerosis and coronary artery disease. By reducing inflammation, magnesium helps protect the heart and blood vessels from damage and dysfunction, lowering the risk of cardiovascular events and reducing your risk of diabetes. [9-11]

 

Cardiovascular Risk Reduction

Combining all these effects, we know adequate magnesium intake significantly improves outcomes. By supporting endothelial function, preventing adverse heart remodeling, and exerting anti-inflammatory effects, adequate blood magnesium levels reduce cardiovascular risk and promote heart health.

 

Magnesium – where to find it?

Now, this is all well and good, but that begs the question – how do I keep my magnesium intake up? 

Luckily, magnesium is present in many readily available food staples, namely nuts, brown rice, and even some cereals and bread! Whether you integrate this into your daily meals or look to nuts like almonds or cashews for a quick snack when peckish, maintaining your daily intake is not at all difficult!

Making some of the food items available or tweaking your diet slightly (for example, using wholegrain bread or brown rice) will quickly help you keep your levels adequate.

 

Food Milligrams (mg) per serving Percent Daily intake*
Pumpkin seeds, roasted, 30g 156 37
Chia seeds, 30g 111 26
Almonds, dry roasted, 30g 80 19
Spinach, boiled, ½ cup 78 19
Cashews, dry roasted, 30g 74 18
Peanuts, oil roasted, ¼ cup 63 15
Cereal, shredded wheat, 2 large biscuits 61 15
Soymilk, plain or vanilla, 1 cup 61 15
Edamame, shelled, cooked, ½ cup 50 12
Potato, baked with skin, 100g 43 10
Rice, brown, cooked, ½ cup 42 10
Yogurt, plain, low fat, 225g 42 10
Breakfast cereals, fortified with 10% of the DV for magnesium, 1 serving 42 10
Oatmeal, instant, 1 packet 36 9
Kidney beans, canned, ½ cup 35 8
Banana, 1 medium 32 8
Salmon, Atlantic, farmed, cooked, 100g 30 7
Milk, 1 cup 24 6
Bread, whole wheat, 1 slice 23 5
Avocado, ½ cup 22 5
Chicken breast, roasted, 100g 25 6
Beef, ground, 90% lean, pan broiled, 100g 23 5
Broccoli, chopped and cooked, ½ cup 12 3
Rice, white, cooked, ½ cup 10 2
Apple, 1 medium 9 2
Carrot, raw, 1 medium 7 2

 

Table 1. Some common magnesium-rich foods. Data sourced from: NIH – Office of Dietary Supplements.

 

For inspiration, see our simple and delicious salmon dish, which incorporates a few of those magnesium-rich foods.

Finally, keeping your magnesium levels within the “normal” range is important, as excess supplementation can lead to adverse effects, such as diarrhea and dangerous heart rhythms. Always consult with your healthcare professional.

Some medications, particularly diuretics (or medications used to treat acid reflux, such as proton pump inhibitors or PPIs), can disrupt normal magnesium homeostasis for those with heart failure or other conditions requiring medications. As such, some of us need just a little bit extra to keep our levels sufficient—always discuss oral magnesium supplementation and your requirements with your healthcare professional.

 

Conclusion

Hopefully, this whirlwind trip around magnesium homeostasis has enhanced your knowledge of this powerful little mineral and why ensuring adequate oral magnesium intake is so important. From better sleep to improved cardiovascular outcomes, magnesium is one of the quiet workhorses of the human body.

Keep an eye out for our upcoming review on different magnesium supplements, and be sure to subscribe to our newsletter to stay updated!

References

  1. Zhang Y, Chen C, Lu L, Knutson KL, Carnethon MR, Fly AD, et al. Association of magnesium intake with sleep duration and sleep quality: findings from the CARDIA study. Sleep. 2022;45(4).
  2. Reno AM, Green M, Killen LG, O’Neal EK, Pritchett K, Hanson Z. Effects of Magnesium Supplementation on Muscle Soreness and Performance. J Strength Cond Res. 2022;36(8):2198-203.
  3. Swaminathan R. Magnesium metabolism and its disorders. Clin Biochem Rev. 2003;24(2):47-66.
  4. Khan AM, Lubitz SA, Sullivan LM, Sun JX, Levy D, Vasan RS, et al. Low serum magnesium and the development of atrial fibrillation in the community: the Framingham Heart Study. Circulation. 2013;127(1):33-8.
  5. Pati G, Mukherjee S, Kumar P, Khan D, Sengupta S. A study of the effects of intravenous magnesium sulphate on post-operative atrial fibrillation in patients undergoing off pump coronary artery bypass grafting (CABG). Indian Journal of Clinical Anaesthesia. 2023;10(1):26-31.
  6. Parsanathan R. Trace element magnesium: a key player in hypertension management. Hypertension Research. 2023;46(10):2442-4.
  7. Shechter M, Sharir M, Labrador MJP, Forrester J, Silver B, Bairey Merz CN. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000;102(19):2353-8.
  8. Tangvoraphonkchai K, Davenport A. Magnesium and Cardiovascular Disease. Adv Chronic Kidney Dis. 2018;25(3):251-60.
  9. Ashique S, Kumar S, Hussain A, Mishra N, Garg A, Gowda BHJ, et al. A narrative review on the role of magnesium in immune regulation, inflammation, infectious diseases, and cancer. J Health Popul Nutr. 2023;42(1):74.
  10. Nielsen FH. Magnesium deficiency and increased inflammation: current perspectives. J Inflamm Res. 2018;11:25-34.
  11. Rosique-Esteban N, Guasch-Ferré M, Hernández-Alonso P, Salas-Salvadó J. Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies. Nutrients. 2018;10(2). 

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other anti-anginals

When first-line therapies for angina, such as beta blockers, calcium channel blockers, and nitrates, prove inadequate or are not well-tolerated, second-line therapies may be considered.
Perhexiline is a unique medication that enhances the heart's ability to utilize fatty acids for energy, reducing its reliance on oxygen and lowering oxygen demand. This action helps improve blood flow and alleviates chest pain in some patients with refractory angina.
Nicorandil is another second-line option with a dual mechanism of action. It opens potassium channels in smooth muscle cells, causing vasodilation and enhancing coronary blood flow. Additionally, nicorandil also stimulates nitric oxide release, further dilating blood vessels and reducing heart workload.
Trimetazidine is an anti-ischemic agent that improves cardiac efficiency by enhancing glucose metabolism and shifting the heart's energy production to a more oxygen-efficient process. As second-line therapies, these medications offer alternative approaches for managing angina in individuals who do not respond adequately to first-line treatments or those experiencing side effects from other medications.

lipid lowering therapies

Lipid-lowering therapies play a critical role in managing coronary artery disease (CAD), a condition characterized by the narrowing of blood vessels that supply the heart. Among the most commonly discussed and debated classes of medications are statins, which effectively reduce cholesterol levels and are widely prescribed to lower the risk of cardiovascular events. Alongside statins, other medications like ezetimibe, fibrates, and niacin are also utilized to target specific aspects of lipid metabolism, such as cholesterol absorption, triglyceride levels, and raising high-density lipoprotein (HDL) cholesterol. Additionally, the introduction of medications that inhibit PCSK9, an enzyme involved in cholesterol metabolism, has provided a promising new approach to further lower LDL cholesterol levels. These PCSK9 inhibitors, such as Repatha (evolocumab), have shown significant efficacy in reducing LDL cholesterol levels in patients with CAD, especially for those who may not respond well to traditional therapies.

Nitrates

Nitrates are widely used to treat angina and provide quick relief for chest pain. Commonly available in the form of sublingual sprays or tablets, patches, and long-acting tablets, nitrates work by dilating blood vessels, allowing for increased blood flow and reduced resistance. This dilation eases the heart's workload, leading to a decreased demand for oxygen and prompt alleviation of angina symptoms. Sublingual nitrates act rapidly and are often used to provide immediate relief during angina attacks, while patches and long-acting tablets are employed for preventive purposes. However, nitrates may cause side effects such as headaches, dizziness, and flushing, which usually subside over time.

calcium channel blockers

Calcium channel blockers, including amlodipine, felodipine, cardizem (diltiazem), and verapamil, are commonly prescribed for the treatment of angina. These medications work by inhibiting the influx of calcium into the muscle cells of the heart and blood vessels, leading to their relaxation. As a result, blood vessels widen, promoting improved blood flow and reduced blood pressure. In the context of angina, this relaxation decreases the heart's workload, lowering the demand for oxygen and alleviating chest pain. Calcium channel blockers offer a valuable treatment option for individuals with angina, but it is essential to be aware of potential side effects, which may include headaches, dizziness, flushing, and ankle swelling.

Beta blockers

Beta blockers, such as metoprolol, propranolol, atenolol, carvedilol, and bisoprolol, play a crucial role in treating angina. By blocking certain receptors in the heart, they effectively reduce heart rate and the force of contraction, thereby easing the heart's workload. This mechanism of action leads to a decreased demand for oxygen, making beta blockers highly effective in relieving chest pain associated with angina. As with any medication, it's important to consider potential side effects, including tiredness, worsened asthma, erectile dysfunction in some males, and more vivid dreams during sleep. Consult your healthcare provider to determine the suitability of beta blockers for managing your angina and overall heart health.

Anti-platelet Medications

Anti-platelet medications play a crucial role in preventing blood clot formation, reducing the risk of serious cardiovascular events such as heart attacks and strokes. Among the widely used anti-platelet drugs are aspirin, clopidogrel, and ticagrelor.

Aspirin: This well-known medication inhibits platelet activation, making it less likely for platelets to stick together and form clots. Aspirin is commonly used for primary and secondary prevention of heart attacks and strokes.

Clopidogrel: As a potent anti-platelet agent, clopidogrel works by blocking specific receptors on platelets, preventing them from aggregating. It is often prescribed to patients with acute coronary syndrome, those undergoing stent procedures, and for some cases of peripheral arterial disease.

Ticagrelor: Ticagrelor is another effective anti-platelet drug that works by inhibiting platelet activation. It is used in acute coronary syndrome, often given alongside aspirin to reduce the risk of heart-related events.