Can increased magnesium intake protect women against life-threatening heart failure?

There is a clear link between magnesium intake and the risk of heart diseases and sudden cardiac death in postmenopausal women, according to a study that is published in Journal of Women’s Health. Unfortunately, many women are not diagnosed with heart disease at a sufficiently early stage. It is also a fact that many postmenopausal women take calcium supplements for bone health. However, if they also lack magnesium, which is responsible for the calcium distribution in the body, the calcium supplements may instead increase the risk of coronary atherosclerosis. According to new and earlier research, we must focus a lot more on telling women how important it is to get enough magnesium at all stages of life – not least after menopause.

The most common cause of death on a global scale is coronary atherosclerosis, a condition also known as ischemic heart disease. Atherosclerosis is the result of deposits of oxidized LDL cholesterol, fat, and calcium on the inside of the coronary arteries that causes thickening and hardening of the blood vessels. The disease develops gradually, in many cases without people noticing. Eventually, various symptoms may occur as a result of the impaired blood supply. In worst case, it can lead to coronary thrombosis and sudden death
Women rarely get contract heart disease before they reach menopause. If they do, it is often because they are genetically prone, but it can also be a result of risk factors such as smoking, birth control pills, or stress. Several international studies have shown that many women are diagnosed with ischemic heart disease way too late. It is also a problem that therapies aimed at treating heart disease in women are based on clinical experience from middle-aged men. In women, the symptoms are not necessarily the same as in men and may include:

• Fatigue following physical exertion
• Breathing difficulty
• Chest tightness
• Abdominal pain
• Heart palpitations
• Dizziness
• Cold sweats
• Nausea
• Pain radiating to the back, neck or jaw

The risk of life-threatening heart failure goes up after menopause

According to the researchers behind the new study, postmenopausal women represent the largest health burden in terms of cardiovascular diseases, including sudden death caused by heart failure. Because of the limited knowledge about the different risk factors that affect the women in this age group, the scientists wanted to look closer at magnesium intake from the diet and the risk of cardiovascular disease and life-threatening heart failure.

The study: More magnesium benefits the circulatory system and protect against heart failure

The scientists studied more than 153,000 postmenopausal women that were already participants of the comprehensive Women’s Health Initiative. Their dietary magnesium intake was calculated by means of special diet questionnaires, methods, and adjustments. During a 10-year follow-up, the scientists registered the rate of ischemic heart disease or death due to sudden cardiac failure.
After adjusting for confounding factors, they could see a clear and statistically significant relation between dietary magnesium intake and heart health. The women with the lowest magnesium intake (189 mg/day) had a far greater risk of ischemic heart disease and death from sudden heart failure. Moreover, the women that got the most magnesium from their diets had healthier cardiovascular systems and a lower risk of cardiovascular disease and sudden death because of heart failure.
The new study is published in Journal of Women’s Health, which is a scientific periodical that is published once a month and focuses on diseases and conditions that are more prevalent among women. The journal also focuses on better methods for prevention, diagnosis, and therapies aimed at health problems that typically affect women.

What effect does magnesium actually have on the cardiovascular system?

Most heart diseases are caused by coronary atherosclerosis that is a result of deposits of oxidized LDL cholesterol, fat, and calcium on the inside of the vessel walls. This arterial plaque causes a thickening of the blood vessels. It is therefore important to remove calcium from the bloodstream and to prevent cholesterol from oxidizing. Magnesium contributes to this in a number of ways.

How magnesium ensures proper distribution of calcium

Magnesium works as door bolt in all cell membranes. It allows 99 percent of the calcium to enter the cells in hard tissues like bones and teeth. At the same time – and this is equally important – magnesium makes sure to maintain a minimal calcium concentration inside the cells of soft tissues such as blood vessels, connective tissue, nerve tissue, muscles, and internal organs.
If you lack magnesium, you have no guarantee that calcium will end up in your bone cells, and you can eventually end up with osteoporosis. What is more, you also risk that too much calcium enters the cells in your soft tissues, including the heart and blood vessels. If these cells are flooded with calcium, it stresses them and may cause atherosclerosis and local inflammation.
It is therefore vital to have the proper balance between calcium and magnesium and NEVER take a calcium supplements without taking magnesium at the same time.

Magnesium activates vitamin D

It is also important to get enough vitamin D, which is necessary for the body’s uptake of calcium. Vitamin D also supports a number of other functions that are relevant for the immune defense, the heart, and the cardiovascular system. When the body synthesizes vitamin D from sun exposure it is in the form of cholecalciferol, which is the same form as the vitamin D in supplements. This form of the nutrient, however, is not biologically active. It is converted in the liver and then in the kidneys with help from different magnesium-containing enzymes. Therefore, if you lack magnesium it reduces your ability to utilize vitamin D and benefit from the countless processes in which vitamin D takes part. Therefore, make sure to get enough magnesium from your diet or by taking a supplement.

Magnesium counteracts inflammation that can cause atherosclerosis

Over the past decades, science has blamed cholesterol for being the main cause of atherosclerosis, but it is not that simple. Atherosclerosis is actually caused by chronic inflammation that affects the cardiovascular system with free radicals and oxidative stress.
After all, cholesterol is an essential compound that we have in all cell membranes, just like it is needed to make steroid hormones and vitamin D. Cholesterol is not dangerous, unless it becomes oxidized by oxidative stress. If this happens, it cannot carry out its many functions. Oxidized cholesterol is consumed by white blood cells (macrophages) and embedded in the blood vessel walls in the form of so-called foam cells. It is therefore chronic inflammation, free radicals, and oxidative stress that are harmful for the circulatory system, not cholesterol as such.
Magnesium helps reduce inflammation and oxidative stress by taking up calcium in the bone, thereby preventing cells in the soft tissues such as blood vessels from being flooded by calcium ions.
Magnesium’s ability to activate vitamin D even contributes to reducing inflammation, as vitamin D helps regulate the immune defense, which is necessary for preventing it from overreacting.
Magnesium also helps control blood sugar levels. It is already a known fact that elevated blood sugar levels and insulin levels contribute to the development of inflammation, type 2 diabetes, and cardiovascular complications that follow in the wake of these diseases.

This is why magnesium deficiencies are so common

There is magnesium in kernels, almonds, nuts, seeds, beans, whole grains, avocado, cabbage and other vegetables, seaweed, and dark chocolate. Still, many people are magnesium-deficient due to factors such as modern farming methods and poor diets. The problem is only made worse by things like overconsumption of alcohol and other stimulants, birth control pills, diuretics, antacids, excessive training and stress that can inhibit the uptake of magnesium or deplete the body’s stores of the nutrient.
Insulin resistance and type 2 diabetes can also leach the body’s magnesium stores, and many of the above-mentioned factors reinforce each other.
Therefore, the actual need for magnesium may be greater than the official recommendation.

References

Jason Li et al. Association of Dietary Magnesium Intake with Fatal Coronary heart Disease and Sudden Cardiac Death. The Health of Women. 2020

Eva Prescott. Kvinder og hjertesygdom. Netdoktor.dk

Gerry K. Schwalfenberg and Stephen J. Genuis. The Importance of Magnesium in Clinical Healthcare. Scientifica (Carro) 2017

Qi Dai el al. Abstract CT093: Bimodal relationship between magnesium supplementation and vitamin D status and metabolism: Results from randomized trial. Cancer Research July 2018

Qi Dai et al. Magnesium status and supplementation influence vitamin D status and metabolism; results from a randomized trial. The American Journal of Clinical Nutrition 2018

Andrea Rosanoff et al. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Interact with Vitamin D and/or Calcium status. Advances in Nutrition 2016

Mark J Bolland et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008