rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2010-6-5-717-721rpcardio-973Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИPOTASSIUM AND MAGNESIUM DRUGS IN THE TREATMENT OF CARDIOVASCULAR DISEASES IN THE PRACTICE OF PRIMARY CARE PHYSICIANПРЕПАРАТЫ КАЛИЯ И МАГНИЯ ПРИ ЛЕЧЕНИИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ В ПРАКТИКЕ ВРАЧА ПЕРВИЧНОГО ЗВЕНА ЗДРАВООХРАНЕНИЯШиловА. М.ShilovA. M.

д.м.н., профессор, заведующий кафедрой неотложных состояний в клинике внутренних болезней

заслуженный деятель науки РФ

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Trubetskaya ul. 8/2, Moscow, 119991

МельникМ. В.MelnikM. V.

д.м.н., профессор кафедры неотложных состояний в клинике внутренних болезней 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Trubetskaya ul. 8/2, Moscow, 119991

melnik.m.v@gmail.comОсияА. О.OsiyaA. O.

к.м.н., ассистент кафедры неотложных состояний в клинике внутренних болезней 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Trubetskaya ul. 8/2, Moscow, 119991

ЛишутаА. С.LishutaA. S.

к.м.н., ассистент кафедры госпитальной терапии №1 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Trubetskaya ul. 8/2, Moscow, 119991

Первый Московский Государственный Медицинский Университет им. И.М.СеченоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation20102201201665717721Copyright © Shilov A.M., Melnik M.V., Osiya A.O., Lishuta A.S., 20162016Шилов А.М., Мельник М.В., Осия А.О., Лишута А.С.Shilov A.M., Melnik M.V., Osiya A.O., Lishuta A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/973

Role of magnesium and potassium deficiency in the development of cardiovascular diseases and their complications is discussed. Results of studies on efficacy of magnesium and potassium drugs in cardiology practice are presented. Preventive role of potassium and magnesium in the progression of atherosclerosis, arterial hypertension, endothelial dysfunction and insulin resistance is shown. The advantages of combined magnesium and potassium drugs are shown.

Обсуждается роль дефицита магния и калия в развитии сердечно-сосудистых заболеваний и их осложнений. Представлены результаты исследований эффективности применения препаратов магния и калия в кардиологической практике. Показано значение калия и магния для предупреждения прогрессирования атеросклероза, артериальной гипертонии, эндотелиальной дисфункции и инсулинорезистентности. Показаны преимущества применения комбинированных препаратов магния и калия.

дефицит калиядефицит магнияартериальная гипертонияаритмииишемическая болезнь сердцаpotassium deficiencymagnesium deficiencyarterial hypertensionarrhythmiasischemic heart diseaseReferencesCapewell S., Ford E.S., Croft J.B. et al. Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America. Bull World Health Organ 2010;88(2): 120-30.Capewell S., Ford E.S., Croft J.B. et al. Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America. Bull World Health Organ 2010;88(2): 120-30.Deckert A., Winkler V., Paltiel A. et al. Time trends in cardiovascular disease mortality in Russia and Ger￾many from 1980 to 2007 - are there migration effects? BMC Public Health 2010;10:488.Deckert A., Winkler V., Paltiel A. et al. Time trends in cardiovascular disease mortality in Russia and Ger￾many from 1980 to 2007 - are there migration effects? BMC Public Health 2010;10:488.Cífková R., Skodová Z., Bruthans J. et al. Longitudinal trends in cardiovascular mortality and blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2007/2008. J Hypertens 2010;28(11):2196-203.Cífková R., Skodová Z., Bruthans J. et al. Longitudinal trends in cardiovascular mortality and blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2007/2008. J Hypertens 2010;28(11):2196-203.Mendis S. The contribution of the Framingham Heart Study to the prevention of cardiovascular disease: a global perspective. Prog Cardiovasc Dis 2010;53(1):10-4.Mendis S. The contribution of the Framingham Heart Study to the prevention of cardiovascular disease: a global perspective. Prog Cardiovasc Dis 2010;53(1):10-4.Weglicki W.B., Mak I.T., Chmielinska J.J. et al. The role of magnesium deficiency in cardiovascular and intestinal inflammation. Magnes Res 2010 [Epub ahead of print]Weglicki W.B., Mak I.T., Chmielinska J.J. et al. The role of magnesium deficiency in cardiovascular and intestinal inflammation. Magnes Res 2010 [Epub ahead of print]Fox C.H., Mahoney M.C., Ramsoomair D., Carter C.A. Magnesium deficiency in African-Americans: does it contribute to increased cardiovascular risk factors? J Natl Med Assoc 2003;95(4):257-62.Fox C.H., Mahoney M.C., Ramsoomair D., Carter C.A. Magnesium deficiency in African-Americans: does it contribute to increased cardiovascular risk factors? J Natl Med Assoc 2003;95(4):257-62.Lücker P.W., WitzmannH.K. Influence of magnesium and potassium deficiency on renal elimination and cardiovascular function demonstrated by impedance cardiography. Magnesium. 1984;3(4-6): 265-73.Lücker P.W., WitzmannH.K. Influence of magnesium and potassium deficiency on renal elimination and cardiovascular function demonstrated by impedance cardiography. Magnesium. 1984;3(4-6): 265-73.Altura B.M., Shah N.C., Jiang X.C. et al. Short-term magnesium deficiency results in decreased levels of serum sphingomyelin, lipid peroxidation, and apoptosis in cardiovascular tissues. Am J Physiol Heart Circ Physiol 2009;297(1):H86-92.Altura B.M., Shah N.C., Jiang X.C. et al. Short-term magnesium deficiency results in decreased levels of serum sphingomyelin, lipid peroxidation, and apoptosis in cardiovascular tissues. Am J Physiol Heart Circ Physiol 2009;297(1):H86-92.Shivakumar K. Pro-fibrogenic effects of magnesium deficiency in the cardiovascular system. Magnes Res 2002;15(3-4):307-15.Shivakumar K. Pro-fibrogenic effects of magnesium deficiency in the cardiovascular system. Magnes Res 2002;15(3-4):307-15.Abbrecht PH. Cardiovascular effects of chronic potassium deficiency in the dog. Am J Physiol 1972;223(3):555-60.Abbrecht PH. Cardiovascular effects of chronic potassium deficiency in the dog. Am J Physiol 1972;223(3):555-60.Vinogradov A.P. Biological role of potassium-40. Nature 1957 ;180(4584):507-8.Vinogradov A.P. Biological role of potassium-40. Nature 1957 ;180(4584):507-8.Pleshchitser A.Ia. Biological role of magnesium. Clin Chem 1958;4(6):429-51.Pleshchitser A.Ia. Biological role of magnesium. Clin Chem 1958;4(6):429-51.Cook N.L., Heuvel C.V., Vink R. Are the transient receptor potential melastatin (TRPM) channels important in magnesium homeostasis following traumatic brain injury? Magnes Res 2009;22(4): 225-34.Cook N.L., Heuvel C.V., Vink R. Are the transient receptor potential melastatin (TRPM) channels important in magnesium homeostasis following traumatic brain injury? Magnes Res 2009;22(4): 225-34.Schlingmann K.P., Gudermann T. A critical role of TRPM channel-kinase for human magnesium transport. J Physiol 2005;566(Pt 2):301-8.Schlingmann K.P., Gudermann T. A critical role of TRPM channel-kinase for human magnesium transport. J Physiol 2005;566(Pt 2):301-8.Shechter M. Magnesium and cardiovascular system. Magnes Res 2010;23(2):60-72.Shechter M. Magnesium and cardiovascular system. Magnes Res 2010;23(2):60-72.Wolf F.I.,.Trapani V., Simonacci M .et al. Magnesium deficiency and endothelial dysfunction: is oxidative stress involved? Magnes Res. 2008;21(1):58-64.Wolf F.I.,.Trapani V., Simonacci M .et al. Magnesium deficiency and endothelial dysfunction: is oxidative stress involved? Magnes Res. 2008;21(1):58-64.Sapna S., Ranjith S.K., Shivakumar K. Cardiac fibrogenesis in magnesium deficiency: a role for circulating angiotensin II and aldosterone. Am J Physiol Heart Circ Physiol. 2006;291(1):H436-40.Sapna S., Ranjith S.K., Shivakumar K. Cardiac fibrogenesis in magnesium deficiency: a role for circulating angiotensin II and aldosterone. Am J Physiol Heart Circ Physiol. 2006;291(1):H436-40.Suga S., Mazzali M., Ray P.E. et al. Angiotensin II type 1 receptor blockade ameliorates tubulointerstitial injury induced by chronic potassium deficiency. Kidney Int. 2002;61(3):951-8.Suga S., Mazzali M., Ray P.E. et al. Angiotensin II type 1 receptor blockade ameliorates tubulointerstitial injury induced by chronic potassium deficiency. Kidney Int. 2002;61(3):951-8.Sugimoto T., Tobian L., Ganguli M.C. High potassium diets protect against dysfunction of endothelial cells in stroke-prone spontaneously hypertensive rats. Hypertension. 1988;11(6 Pt 2):579-85.Sugimoto T., Tobian L., Ganguli M.C. High potassium diets protect against dysfunction of endothelial cells in stroke-prone spontaneously hypertensive rats. Hypertension. 1988;11(6 Pt 2):579-85.Cybulski J., Budaj A., Danielewicz H. et al. A new-onset atrial fibrillation: the incidence of potassium and magnesium deficiency. The efficacy of intravenous potassium/magnesium supplementation in cardioversion to sinus rhythm. Kardiol Pol. 2004;60(6):578-81.Cybulski J., Budaj A., Danielewicz H. et al. A new-onset atrial fibrillation: the incidence of potassium and magnesium deficiency. The efficacy of intravenous potassium/magnesium supplementation in cardioversion to sinus rhythm. Kardiol Pol. 2004;60(6):578-81.Lewis R., Durnin C., McLay J. et al. Magnesium deficiency may be an important determinant of ventricular ectopy in digitalised patients with chronic atrial fibrillation. Br J Clin Pharmacol. 1991;31(2): 200-3.Lewis R., Durnin C., McLay J. et al. Magnesium deficiency may be an important determinant of ventricular ectopy in digitalised patients with chronic atrial fibrillation. Br J Clin Pharmacol. 1991;31(2): 200-3.Sahin V., Kaplan M., Bilsel S. et al. The relation between blood and tissue magnesium levels and development of atrial fibrillation after coronary artery bypass surgery. Anadolu Kardiyol Derg. 2010;10(5):446-51.Sahin V., Kaplan M., Bilsel S. et al. The relation between blood and tissue magnesium levels and development of atrial fibrillation after coronary artery bypass surgery. Anadolu Kardiyol Derg. 2010;10(5):446-51.Bakhsh M., Abbas S., Hussain R.M. et al. Role of magnesium in preventing post-operative atrial fibrillation after coronary artery bypass surgery. J Ayub Med Coll Abbottabad. 2009;21(2):27-9.Bakhsh M., Abbas S., Hussain R.M. et al. Role of magnesium in preventing post-operative atrial fibrillation after coronary artery bypass surgery. J Ayub Med Coll Abbottabad. 2009;21(2):27-9.Piper S.N., Kiessling A.H., Suttner S.W. et al. Prevention of atrial fibrillation after coronary artery by￾pass graft surgery using a potassium-magnesium-aspartate solution (Inzolen). Thorac Cardiovasc Surg. 2007;55(7):418-23.Piper S.N., Kiessling A.H., Suttner S.W. et al. Prevention of atrial fibrillation after coronary artery by￾pass graft surgery using a potassium-magnesium-aspartate solution (Inzolen). Thorac Cardiovasc Surg. 2007;55(7):418-23.Barbagallo M., Belvedere M., Dominguez L.J. Magnesium homeostasis and aging. Magnes Res. 2009;22(4):235-46.Barbagallo M., Belvedere M., Dominguez L.J. Magnesium homeostasis and aging. Magnes Res. 2009;22(4):235-46.Sjögren A., Edvinsson L., Fallgren B. Magnesium deficiency in coronary artery disease and cardiac arrhythmias. J Intern Med. 1989;226(4):213-22.Sjögren A., Edvinsson L., Fallgren B. Magnesium deficiency in coronary artery disease and cardiac arrhythmias. J Intern Med. 1989;226(4):213-22.Bloomgarden Z.T. American Diabetes Association scientific sessions, 1995. Magnesium deficiency, atherosclerosis, and health care. Diabetes Care. 1995;18(12):1623-7.Bloomgarden Z.T. American Diabetes Association scientific sessions, 1995. Magnesium deficiency, atherosclerosis, and health care. Diabetes Care. 1995;18(12):1623-7.Magnesium deficiency and ischemic heart disease. Nutr Rev. 1988;46(9):311-2.Magnesium deficiency and ischemic heart disease. Nutr Rev. 1988;46(9):311-2.Wojtovich A.P., Brookes P.S. The endogenous mitochondrial complex II inhibitor malonate regulates mitochondrial ATP-sensitive potassium channels: implications for ischemic preconditioning. Biochim Biophys Acta. 2008;1777(7-8):882-9.Wojtovich A.P., Brookes P.S. The endogenous mitochondrial complex II inhibitor malonate regulates mitochondrial ATP-sensitive potassium channels: implications for ischemic preconditioning. Biochim Biophys Acta. 2008;1777(7-8):882-9.McCully J.D., Uematsu M., Parker R.A., Levitsky S. Adenosine-enhanced ischemic preconditioning provides enhanced postischemic recovery and limitation of infarct size in the rabbit heart. J Thorac Cardiovasc Surg. 1998;116(1):154-62.McCully J.D., Uematsu M., Parker R.A., Levitsky S. Adenosine-enhanced ischemic preconditioning provides enhanced postischemic recovery and limitation of infarct size in the rabbit heart. J Thorac Cardiovasc Surg. 1998;116(1):154-62.Turlapaty P.D., Altura B.M. Magnesium deficiency produces spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science. 1980 ;208(4440):198-200.Turlapaty P.D., Altura B.M. Magnesium deficiency produces spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science. 1980 ;208(4440):198-200.Ozono R., Oshima T., MatsuuraH. et al. Systemic magnesium deficiency disclosed by magnesium loading test in patients with essential hypertension. Hypertens Res. 1995;18(1):39-42.Ozono R., Oshima T., MatsuuraH. et al. Systemic magnesium deficiency disclosed by magnesium loading test in patients with essential hypertension. Hypertens Res. 1995;18(1):39-42.Dyckner T.,Wester P.O.Magnesium deficiency in congestive heartfailure. Acta Pharmacol Toxicol (Copenh). 1984;54 Suppl 1:119-23.Dyckner T.,Wester P.O.Magnesium deficiency in congestive heartfailure. Acta Pharmacol Toxicol (Copenh). 1984;54 Suppl 1:119-23.Shechter M., Sharir M., Labrador M.J. et al. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000 ;102(19):2353-8.Shechter M., Sharir M., Labrador M.J. et al. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000 ;102(19):2353-8.Liao F., Folsom A.R., Brancati F.L. Is low magnesium concentration a risk factor for coronary heart disease? The Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 1998;136(3):480-90.Liao F., Folsom A.R., Brancati F.L. Is low magnesium concentration a risk factor for coronary heart disease? The Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 1998;136(3):480-90.Ueshima K. Magnesium and ischemic heart disease: a review of epidemiological, experimental, and clinical evidences. Magnes Res. 2005;18(4):275-84.Ueshima K. Magnesium and ischemic heart disease: a review of epidemiological, experimental, and clinical evidences. Magnes Res. 2005;18(4):275-84.Lima Mde L., Cruz T., Rodrigues L.E. et al. Serum and intracellular magnesium deficiency in patients with metabolic syndrome--evidences for its relation to insulin resistance. Diabetes Res Clin Pract. 2009;83(2):257-62.Lima Mde L., Cruz T., Rodrigues L.E. et al. Serum and intracellular magnesium deficiency in patients with metabolic syndrome--evidences for its relation to insulin resistance. Diabetes Res Clin Pract. 2009;83(2):257-62.Witte K.K., Clark A.L. Micronutrients and their supplementation in chronic cardiac failure. An update beyond theoretical perspectives. Heart Fail Rev. 2006;11(1):65-74.Witte K.K., Clark A.L. Micronutrients and their supplementation in chronic cardiac failure. An update beyond theoretical perspectives. Heart Fail Rev. 2006;11(1):65-74.Sueta C.A., Clarke S.W., Dunlap S.H. Effect of acute magnesium administration on the frequency of ventricular arrhythmia in patients with heart failure. Circulation, 1994; 89: 660 - 666.Sueta C.A., Clarke S.W., Dunlap S.H. Effect of acute magnesium administration on the frequency of ventricular arrhythmia in patients with heart failure. Circulation, 1994; 89: 660 - 666.Banai S., Schuger C. Magnesium sulfate is the treatment for torsades de pointes if the right dose is given. Am J Cardiol. 1990 15;65(3):266.Banai S., Schuger C. Magnesium sulfate is the treatment for torsades de pointes if the right dose is given. Am J Cardiol. 1990 15;65(3):266.Hoshino K., Ogawa K., Hishitani T. et al. Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndrome. Pediatr Int. 2006;48(2):112-7.Hoshino K., Ogawa K., Hishitani T. et al. Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndrome. Pediatr Int. 2006;48(2):112-7.Zehender M., Meinertz T., Just H. Magnesium deficiency and magnesium substitution. Effect on ventricular cardiac arrhythmias of various etiology. Herz. 1997;22 Suppl 1:56-62.Zehender M., Meinertz T., Just H. Magnesium deficiency and magnesium substitution. Effect on ventricular cardiac arrhythmias of various etiology. Herz. 1997;22 Suppl 1:56-62.Zhi Y.F.,Huang Y.S., Xu B.S., Wang S.R. Clinical investigation of the protective effects of potassium magnesium aspartate against arrhythmia and its possible anti-oxidative mechanism. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007;19(11):662-6.Zhi Y.F.,Huang Y.S., Xu B.S., Wang S.R. Clinical investigation of the protective effects of potassium magnesium aspartate against arrhythmia and its possible anti-oxidative mechanism. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007;19(11):662-6.Kühn P., Oberthaler G., Oswald J. Anti-arrhythmia effectiveness of potassium-magnesium-aspartate infusion. Wien Med Wochenschr. 1991;141(3):64-5.Kühn P., Oberthaler G., Oswald J. Anti-arrhythmia effectiveness of potassium-magnesium-aspartate infusion. Wien Med Wochenschr. 1991;141(3):64-5.

The authors declare that there are no conflicts of interest present.