Physiological and pathophysiological role of magnesium in the cardiovascular system: implications in hypertension

Attention is growing for a potential role of magnesium in the pathoetiology of cardiovascular disease, Magnesium modulates mechanical, electrical and structural functions of cardiac and vascular cells, and small changes in ex tracellular magnesium levels and/or intracellular free magnesium concentrat ion may have significant effects on cardiac excitability and on vascular to ne, contractility and reactivity, Thus, magnesium may be important in the p hysiological regulation of blood pressure whereas alterations in cellular m agnesium metabolism could contribute to the pathogenesis of blood pressure elevation, Although most epidemiological and experimental studies support a pathological role for magnesium in the etiology and development of hyperte nsion, data from clinical studies have been less convincing. Furthermore, t he therapeutic value of magnesium in the management of essential hypertensi on is unclear, The present review discusses the molecular, biochemical, phy siological and pharmacological roles of magnesium in the regulation of vasc ular function and blood pressure and introduces novel concepts relating to magnesium as a second messenger in intracellular signaling in cardiovascula r cells. In addition, alterations in magnesium regulation in experimental a nd clinical hypertension and the potential antihypertensive therapeutic eff ects of magnesium are addressed, I Hypertens 2000, 18:1177-1191 (C) Lippinc ott Williams & Wilkins.