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Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis.

Abstract

Previously, we examined 44 human studies involving oral magnesium (Mg) supplementation for hypertension (HT), sorting them according to HT status, Mg dose and anti-hypertensive medication usage. We found that while some studies reported a significant lowering of blood pressure with Mg supplementation, others did not. We present here our first meta-analysis of a uniform subset from this series of studies. Seven studies, involving 135 hypertensive subjects on anti-hypertensive medication continuously for at least six months, with no more than a two-week washout and with a mean starting systolic blood pressure (SBP)>155 mmHg, demonstrated a mean change of -18.7 mmHg [95% CI=-14.95 to -22.45] p<0.0001 and an effect size test (Cohen's d)=1.19, i.e. a large and highly significant effect. Meta-analysis of diastolic blood pressure (DBP) for these same seven studies showed a mean change in DBP of -10.9 mmHg [95% CI=-8.73 to -13.1], p<0.0001, with an effect size test (Cohen's d)=1.19. Other studies from our original collection, approaching, but not meeting the >155 mmHg starting SBP values or not complying as regards anti-hypertensive medication usage, showed mean changes in both SBP and DBP with oral Mg that, while not approaching the high-responder values of the present study, appeared to include some high-responder subjects combined with low- or non-responder subjects. This uniform subset of seven studies showed a strong effect of Mg treatment in hypertension, which is in stark contrast to results of three other meta-analyses. Using non-uniform sets of studies, the small effects reported in previous meta-analyses may reflect a blending of dissimilar studies, which acted to seriously underestimate the potential of Mg in hypertension in some (but not all) subjects. Within studies, blending of non-, moderate and highresponder subjects in any one study might mask strong effects of Mg treatment in some subjects.

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  • Authors+Show Affiliations

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    Center for Magnesium Education & Research, 13-1255 Malama St., Pahoa, HI 96778 USA.

    Source

    Magnesium research 26:3 pg 93-9

    MeSH

    Administration, Oral
    Antihypertensive Agents
    Blood Pressure
    Dietary Supplements
    Humans
    Magnesium

    Pub Type(s)

    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    24134861

    Citation

    Rosanoff, Andrea, and Michael R. Plesset. "Oral Magnesium Supplements Decrease High Blood Pressure (SBP>155 mmHg) in Hypertensive Subjects On Anti-hypertensive Medications: a Targeted Meta-analysis." Magnesium Research, vol. 26, no. 3, 2013, pp. 93-9.
    Rosanoff A, Plesset MR. Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. Magnes Res. 2013;26(3):93-9.
    Rosanoff, A., & Plesset, M. R. (2013). Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. Magnesium Research, 26(3), pp. 93-9. doi:10.1684/mrh.2013.0343.
    Rosanoff A, Plesset MR. Oral Magnesium Supplements Decrease High Blood Pressure (SBP>155 mmHg) in Hypertensive Subjects On Anti-hypertensive Medications: a Targeted Meta-analysis. Magnes Res. 2013;26(3):93-9. PubMed PMID: 24134861.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. AU - Rosanoff,Andrea, AU - Plesset,Michael R, PY - 2013/10/19/entrez PY - 2013/10/19/pubmed PY - 2014/11/6/medline KW - hypertension KW - meta-analysis KW - oral magnesium treatment SP - 93 EP - 9 JF - Magnesium research JO - Magnes Res VL - 26 IS - 3 N2 - Previously, we examined 44 human studies involving oral magnesium (Mg) supplementation for hypertension (HT), sorting them according to HT status, Mg dose and anti-hypertensive medication usage. We found that while some studies reported a significant lowering of blood pressure with Mg supplementation, others did not. We present here our first meta-analysis of a uniform subset from this series of studies. Seven studies, involving 135 hypertensive subjects on anti-hypertensive medication continuously for at least six months, with no more than a two-week washout and with a mean starting systolic blood pressure (SBP)>155 mmHg, demonstrated a mean change of -18.7 mmHg [95% CI=-14.95 to -22.45] p<0.0001 and an effect size test (Cohen's d)=1.19, i.e. a large and highly significant effect. Meta-analysis of diastolic blood pressure (DBP) for these same seven studies showed a mean change in DBP of -10.9 mmHg [95% CI=-8.73 to -13.1], p<0.0001, with an effect size test (Cohen's d)=1.19. Other studies from our original collection, approaching, but not meeting the >155 mmHg starting SBP values or not complying as regards anti-hypertensive medication usage, showed mean changes in both SBP and DBP with oral Mg that, while not approaching the high-responder values of the present study, appeared to include some high-responder subjects combined with low- or non-responder subjects. This uniform subset of seven studies showed a strong effect of Mg treatment in hypertension, which is in stark contrast to results of three other meta-analyses. Using non-uniform sets of studies, the small effects reported in previous meta-analyses may reflect a blending of dissimilar studies, which acted to seriously underestimate the potential of Mg in hypertension in some (but not all) subjects. Within studies, blending of non-, moderate and highresponder subjects in any one study might mask strong effects of Mg treatment in some subjects. SN - 1952-4021 UR - https://www.unboundmedicine.com/medline/citation/24134861/full_citation L2 - http://www.john-libbey-eurotext.fr/medline.md?doi=10.1684/mrh.2013.0343 DB - PRIME DP - Unbound Medicine ER -