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Title: Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study

Author
item HRUBY, ADELA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item MEIGS, JAMES - Massachusetts General Hospital
item O'DONNELL, CHRISTOPHER - National Heart, Lung And Blood Institute(NHLBI, NIH)
item JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item MCKEOWN, NICOLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item HOFFMANN, UDO - Massachusetts General Hospital

Submitted to: Journal of the American College of Cardiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/25/2013
Publication Date: 11/27/2013
Citation: Hruby, A., Meigs, J.B., O'Donnell, C.J., Jacques, P.F., Mckeown, N.M., Hoffmann, U. 2013. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study. Journal of the American College of Cardiology. 7(1):59-69.

Interpretive Summary: Coronary artery calcification (CAC) and abdominal aortic calcification (AAC) are measures of advanced atherosclerosis, which is hardening and narrowing of arteries due to plaque formation. CAC and AAC are known to predict morbidity and mortality from cardiovascular disease (CVD). Dietary magnesium, found in a broad range of foods including whole grains, green leafy vegetables, almonds, coffee, and dark chocolate, has been linked to many aspects of cardiovascular health, and previous research has suggested that this mineral may lower risk of stroke and other cardiac outcomes such as fatal coronary heart disease. Thus, we believe it is possible that magnesium may potentially protect against the atherosclerosis (calcification) that ultimately leads to CVD. Only one previous study has examined dietary magnesium in association with CAC in a generally healthy population, and this study observed no additional benefits of magnesium with regards to CAC or a reduction in CVD risk. No study has examined the association between magnesium intake and AAC. Therefore, we tested the hypothesis that higher magnesium intake is associated with lower levels of CAC and AAC in a generally healthy population, using data from approximately 2,600 participants in the Framingham Heart Study. Our results suggested that a 50-mg/day increment in self-reported total magnesium intake was associated with 22% lower CAC and 12% lower AAC. In addition, the odds of having any CAC were 58% lower, and the odds of having any AAC were 34% lower in individuals who consumed the highest amount of magnesium compared to the lowest amounts. In conclusion, magnesium intake may protect against the hardening and narrowing of arteries due to calcification, and this may contribute to why magnesium appears to protect against stroke and CVD.

Technical Abstract: OBJECTIVES: The aim of this study was to examine whether magnesium intake is associated with coronary artery calcification (CAC) and abdominal aortic calcification (AAC). BACKGROUND: Animal and cell studies suggest that magnesium may prevent calcification within atherosclerotic plaques underlying cardiovascular disease. Little is known about the association of magnesium intake and atherosclerotic calcification in humans. METHODS: We examined cross-sectional associations of self-reported total (dietary and supplemental) magnesium intake estimated by food frequency questionnaire with CAC and AAC in participants of the Framingham Heart Study who were free of cardiovascular disease and underwent Multi-Detector Computed Tomography (MDCT) of the heart and abdomen (n=2,695; age: 53 ± 11 years), using multivariate-adjusted Tobit regression. CAC and AAC were quantified using modified Agatston scores (AS). Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, fasting insulin, total-to-high-density lipoprotein cholesterol ratio, use of hormone replacement therapy (women only), menopausal status (women only), treatment for hyperlipidemia, hypertension, cardiovascular disease prevention, or diabetes, as well as self-reported intake of calcium, vitamins D and K, saturated fat, fiber, alcohol, and energy. Secondary analyses included logistic regressions of CAC and AAC outcomes as cut-points (AS >0 and AS $90th percentile for age and sex), as well as sex-stratified analyses. RESULTS: In fully adjusted models, a 50-mg/day increment in self-reported total magnesium intake was associated with 22% lower CAC (p < 0.001) and 12% lower AAC (p 1/4 0.07). Consistent with these observations, the odds of having any CAC were 58% lower (p trend: <0.001) and any AAC were 34% lower (p trend: 0.01), in those with the highest compared to those with the lowest magnesium intake. Stronger inverse associations were observed in women than in men. CONCLUSIONS: In community-dwelling participants free of cardiovascular disease, self reported magnesium intake was inversely associated with arterial calcification, which may play a contributing role in magnesium’s protective associations in stroke and fatal coronary heart disease.