2019 review: Mg for CV Health (and more)

[jimmylegs]

Prevention of Cardiovascular Disease: Screening for Magnesium Deficiency (2019)
https://www.hindawi.com/journals/crp/2019/4874921/abs/
http://downloads.hindawi.com/journals/c ... 874921.pdf

"Abstract
Magnesium is an essential mineral naturally present in the human body, where it acts as cofactor in several enzymatic reactions. Magnesium is a key cardiovascular regulator, which maintains electrical, metabolic, and vascular homeostasis. Moreover, magnesium participates in inflammation and oxidative processes. In fact, magnesium deficiency is involved in the pathophysiology of arterial hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome, endothelial dysfunction, coronary artery disease, cardiac arrhythmias, and sudden cardiac death. In consideration of the great public-health impact of cardiovascular disease, the recognition of the negative effects of magnesium deficiency suggests the possible role of hypomagnesaemia as cardiovascular risk factor and the use of serum magnesium level for the screening and prevention of cardiovascular risk factors and cardiovascular diseases. Moreover, it might help with the identification of new therapeutical strategies for the management of cardiovascular disease through magnesium supplementation.
...
the recognition of the possible role of hypomagnesaemia as risk factor for CV health, along with the underestimation of the importance of this mineral in daily clinical practice, makes serum Mg2+ level suitable for the screening and prevention of CVD and opens new therapeutic scenarios with the possibility of reducing CV risk profile and treating CVDs through Mg2+ supplementation.
...
there are several studies reporting an inverse association between serum Mg2+ level, Mg2+ supplementation, and CVD. )ese evidences suggest that this ion could be monitored for screening and prevention of CVD and possibly supplemented as an adjunctive pharmacotherapy for CVD
...
the Framingham Heart Study highlighted how in the comparison between individuals belonging to the lowest quartile or the upper quartiles of serum Mg2+, the first group was about 50% more likely to go to atrial fibrillation than the latter. )erefore, it resulted that low-serum Mg2+ levels are moderately associated with the onset of atrial fibrillation also in people without cardiovascular diseases
...
a cohort of more than fourteen thousand persons, distributed according to the value of their serum Mg2+. )e results showed that people at the higher quartile of serum Mg2+ had a significantly lower risk of sudden death compared to individuals at
the lower quartile, and these findings were confirmed also after the adjustment for the major potential confounders of
Mg2+-SCD relationship, like hypertension, diabetes, serum K+ concentrations, or use of diuretics [100].
...
Nevertheless, the aforementioned studies have several limitations. First of all, serum Mg2+ does not unequivocally reflect the intracellular concentration of this ion, which better correlates with Mg2+ functions [101, 102], thus possibly affecting the results of the studies. Maybe, the evaluation of the intracellular amount of Mg2+ within lymphocytes and erythrocytes would be likely more accurate and would correlate better with intramyocardial Mg2+ [103]. Secondly, a possible limitation of the cited epidemiological studies is the use of indirect methods, such as food questionnaires, to determine Mg2+ intake; thus, it is not possible to discriminate among the effect of Mg2+ and residual effect derived from the intake of other microelements. Moreover, it is not possible to determine the amount of supplemented Mg2+ effectively absorbed and utilized.
Another limitation is the different types of Mg2+ formulations used for the supplementation. the studies about the effect of Mg2+ intake on CV health use different Mg2+ formulations, both organic and inorganic, but it have been demonstrated that there are differences in the bioavailability among formulations. these differences could influence the results of the studies. Lastly, some cited meta-analyses present heterogeneity between the studies, possibly affecting the reliability of statistical analysis. these limitations suggest that new large prospective randomized trial is necessary to elucidate the association among Mg and CV health and to assess the benefits and the usefulness of Mg supplementation in the prevention and treatment of CVD."

yup!

Dietary and lifestyle factors in multiple sclerosis progression: results from a 5-year longitudinal MRI study (2019)
https://link.springer.com/article/10.10 ... 19-09208-0

Abstract
Background
Evidence regarding the role, if any, of dietary and lifestyle factors in the pathogenesis of multiple sclerosis (MS) is poorly understood.

Objective
To assess the effect of lifestyle-based risk factors linked to cardiovascular disease (CVD) on clinical and MRI-derived MS outcomes.

Methods
The study enrolled 175 MS or clinically isolated syndrome (CIS) patients and 42 age- and sex-matched healthy controls (HCs) who were longitudinally followed for 5.5 years. The 20-year CVD risk was calculated by Healthy Heart Score (HHS) prediction model which includes age, smoking, body mass index, dietary intake, exercise, and alcohol consumption. Baseline and follow-up MRI scans were obtained and cross-sectional and longitudinal changes of T2-lesion volume (LV), whole brain volume (WBV), white matter volume (WMV), gray matter volume (GMV), and lateral ventricular volume (LVV) were calculated.

Results
After correcting for disease duration, the baseline HHS values of the MS group were associated with baseline GMV (rs = − 0.20, p = 0.01), and longitudinal LVV change (rs = 0.19, p = 0.01). The association with LVV remained significant after adjusting for baseline LVV volumes (rs = 0.2, p = 0.008) in MS patients. The diet component of the HHS was associated with the 5-year T2-LV accrual (rs = − 0.191, p = 0.04) in MS. In the HC group, the HHS was associated with LVV (rs = 0.58, p < 0.001), GMV (rs = − 0.57, p < 0.001), WBV (rs = − 0.55, p = 0.001), T2-LV (rs = 0.41, p = 0.027), and WMV (rs = − 0.38, p = 0.042). Additionally, the HC HHS was associated with the 5-year change in LVV (rs = 0.54, p = 0.001) and in WBV (rs = − 0.45, p = 0.011).

Conclusion
Lifestyle risk factors contribute to accelerated central brain atrophy in MS patients, whereas unhealthier diet is associated with MS lesion accrual. Despite the lower overall effect when compared to HCs, lifestyle-based modifications may still provide a beneficial effect on reducing brain atrophy in MS patients.

Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis (2016)
https://jnnp.bmj.com/content/87/2/181.short

Abstract
Background Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS).

Objectives To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes.

Methods In a prospective study, 326 patients with relapsing–remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status.

Results Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p=0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥2 CV risks (p=0.003), while the frequency of ≥3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p=0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p<0.05), while overweight/obesity was associated with increased T1-LV (p<0.39) and smoking with decreased whole brain volume (p=0.049). Increased lateral ventricle volume was associated with heart disease (p=0.029) in CIS.

Conclusions Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.