Calcium metabolism, arterial stiffness and 24-hour blood pressure monitoring data in postmenopausal women with magnesium deficiency, hypertension, and heart failure

Abstract

Aim. To assess the calcium metabolism, arterial stiffness and 24-hour blood pressure (BP) monitoring data in postmenopausal women with magnesium deficiency, hypertension, and heart failure with preserved ejection fraction (HFpEF) Material and methods. The study involved 140 female patients with hypertension complicated by HFpEF, aged 52 to 76 years. Depending on the results of magnesium-tolerance test, 2 groups were selected. The first group consisted of 72 females with magnesium deficiency, and the second (control) group (n=68) — without magnesium deficiency. Calcium metabolism was assessed using calcium-tolerance test. Twenty-four-hour blood pressure monitoring and arterial stiffness was determined using an automatic blood pressure monitor. Results. Patients with magnesium deficiency had a lower calcium excretion and return to baseline blood calcium levels compared with group 2 (p<0,001). The presence of magnesium deficiency was associated with an increase in 24-hour BP variability (16,9 [13,3; 20,69] mm Hg vs 12,9 [11,7; 17,42] mm Hg; p=0,001), rate of morning BP rise (12,5 [9,7; 13,6] mm Hg/h vs 9,5 [8,1; 10,9] mm Hg/h; p<0,001) and indexed systolic BP (21,2 [19,5; 25,1] mm Hg vs 19,5 [16,5; 23,9] mm Hg; p=0,007). In women with magnesium deficiency, BP profiles of non-dipper and night-peaker were more common (p<0,05). Pulse wave velocity (11,92 [10,06; 14,47] m/s vs 10,87 [8,41; 13,20] m/s; p=0,005) and central pulse pressure (70,2±13,3 mm Hg vs 63,5±12,5 mm Hg; p=0,003) were also higher in group 1. Also, a correlation (ρ=-0,610, p<0,001) was found between the rate of exercise-induced decrease in blood calcium and the pulse wave velocity. Conclusion. In women with hypertension and HFpEF, there were no differences in mean 24-hour BP values, while more unfavorable BP profiles and arterial stiffness indicators were revealed, which is mediated by impaired сalcium metabolism.