title: Association of hypermagnesemia and blood pressure in the critically ill.
abstract: BACKGROUND
  Although magnesium is important in the biology of blood pressure regulation, little clinical data exist on the association of hypermagnesemia and blood pressure.
  
  
  METHODS
  We examined the association of hypermagnesemia and SBP in a cross-sectional study of 10 521 ICU patients from a single tertiary care medical center, 6% of whom had a serum magnesium above 2.6 mg/dl at time of admission.
  
  
  RESULTS
  In a multivariable analysis, hypermagnesemia was associated with SBP 6.2 mmHg lower [95% confidence interval (CI) -8.2, -4.2, P < 0.001] than in patients with admission values of serum magnesium 2.6 mg/dl or less. Each mg/dl increase in serum magnesium was associated with a decrease in SBP of 4.3 mmHg (95% CI -5.5, -3.1, P < 0.001). In addition, hypermagnesemic patients had a 2.48-fold greater likelihood (95% CI 2.06, 3.00, P < 0.001) of receiving intravenous vasopressors during the first 24 h of ICU care, independent of admission SBP.
  
  
  CONCLUSIONS
  Our findings add support to the biologic importance of magnesium regulation in blood pressure control.
authors.affiliation: aBeth Israel Deaconess Medical Center, Department of Medicine bHarvard-MIT Division of Health Sciences and Technology cSchool of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Leo A
authors.initials: LA
authors.lastname: Celi
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
authors.forename: Joon
authors.initials: J
authors.lastname: Lee
authors.forename: Rachel
authors.initials: R
authors.lastname: Nelson
authors.forename: Seth L
authors.initials: SL
authors.lastname: Alper
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: Roger G
authors.initials: RG
authors.lastname: Mark
authors.forename: John
authors.initials: J
authors.lastname: Danziger
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents; D008274:Magnesium
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