Hypermagnesemia predicts mortality in elderly with congestive heart disease: relationship with laxative and antacid use.
The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure (CHF) admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients > or = 65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their demographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypomagnesemia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hypermagnesemia in respect to normomagnesemia group, except for slightly higher levels of creatininemia (1.35 +/- 0.61 vs. 1.13 +/- 0.55 mg/dL, respectively; p < 0.02), greater disability (lost ADL, 2.69 +/- 1.57 vs. 2.15 +/- 1.56, respectively; p < 0.05), more mortality for CHF (32.6 vs. 48.3%; p < 0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p < 0.0001). Patients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32 +/- 15.93 vs. 22.46 +/- 16.16 months; p < 0.05), and this finding remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal failure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs.
Corbi
Graziamaria
G
Rehabilitative Cardiology Unit of S. Maugeri Foundation, Scientific Institute of Telese/Campoli, IRCCS, Telese Terme, Italy. graziamaria.corbi@unina2.it
Acanfora
Domenico
D
Iannuzzi
Gian Luca
GL
Longobardi
Giancarlo
G
Cacciatore
Francesco
F
Furgi
Giuseppe
G
Filippelli
Amelia
A
Rengo
Giuseppe
G
Leosco
Dario
D
Ferrara
Nicola
N
D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D006801:Humans; D054368:Laxatives / Q000009:adverse effects*; D008274:Magnesium / Q000097:blood*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
D000863:Antacids; D054368:Laxatives; D008274:Magnesium