Nonprescription Magnesium Supplement Use and Risk of Heart Failure in Patients With Diabetes: A Target Trial Emulation
Cheng Y, Zullo AR, Yin Y, Shao Y, Liu S, Zeng-Treitler Q, Wu WC
Journal of the American Heart Association · 4 citations
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- National Institute on Aging
- Government
- National Heart, Lung, and Blood Institute
- Government
- NHLBI NIH HHS
- Government
- NIA NIH HHS
- Grants
- National Institute on Aging (RF1AG069121); National Heart, Lung, and Blood Institute (R01 HL156518)
Based on 4 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2025-03-26 · J Am Heart Assoc · vol. 14 · issue 7 · p. e038870
- Publisher
- Wiley
- Cited
- 4 citations · more than 84% of similar papers · 2.0× the field average
- References
- 56 works
- Access
- Open access (journal) · CC-BY-NC-ND
- Research areas
- Magnesium in Health and Disease · Parathyroid Disorders and Treatments · Potassium and Related Disorders
- Keywords
- Medicine, Hazard ratio, Interquartile range, Cohort, Internal medicine, Proportional hazards model, Adverse effect, Diabetes mellitus, Stroke (engine), Cohort study, Myocardial infarction, Ambulatory, Confidence interval, Endocrinology
- MeSH
- humans, diabetes mellitus, magnesium, incidence, risk assessment, risk factors, dietary supplements, aged, middle aged, united states, female, male, heart failure
7 authors
From US
- Yan ChengGeorge Washington University; Washington DC VA Medical Center
- Andrew R. ZulloBrown University; Providence VA Medical Center
- Ying YinGeorge Washington University; Washington DC VA Medical Center
- Yijun ShaoGeorge Washington University; Washington DC VA Medical Center
- Simin LiuUniversity of California, Irvine; University of California System
- Qing Zeng‐TreitlerGeorge Washington University; Washington DC VA Medical Center
Abstract
Background
Both diabetes and low magnesium-containing food intake may increase the risk of heart failure (HF). However, the effect of nonprescription magnesium supplements on the risk of HF or major adverse cardiac events in patients with diabetes is unknown.
Methods and results
Using a target-trial-emulation approach, we assembled a national cohort of 94 239 veterans ≥40 years with diabetes, without prior HF or magnesium use, who received ambulatory care in the US veterans-health care system documented by electronic clinic notes between January 1, 2006 and December 31, 2020. A natural language processing approach was used to detect self-reported magnesium-supplement use from clinic notes, n=17 619 were identified as users versus n=76 620 as nonusers. Using inverse probability treatment weighting, we constructed a cohort balanced in 88 baseline characteristics between users and nonusers. The primary outcome was incident HF. Secondary outcomes were major adverse cardiac events (myocardial infarction, stroke, HF hospitalization, or death). Hazard ratios (HRs) associated with magnesium-supplement use and outcomes were estimated in the inverse probability treatment weighting weighted cohort using Cox regression. The inverse probability treatment weighting weighted cohort had a mean age of 67.4±10.3 years; 18.4% were Black, and 5.1% were women. The mean duration of magnesium-supplement use was 3.5±3.1 (interquartile range, 1.1-5.1) years. Incident HF occurred in 8.0% of users and 9.7% of nonusers of magnesium supplements (HR, 0.94 [95% CI, 0.89-0.99]). Magnesium-supplement use was also associated with a reduced risk of major adverse cardiac events (HR, 0.94 [95% CI, 0.90-0.97]).
Conclusions
Long-term nonprescription magnesium supplement use was associated with a lower risk of incident HF and major adverse cardiac events in patients with diabetes. These findings should be replicated in randomized controlled trials.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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