Magnesium and Hypertension
Magnesium and Hypertension
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Content
0.199 -> hi my name is Lauren Deipolyi and this
is a presentation regarding magnesium
5.31 -> supplements potential affects on stage 1
hypertension in adults. Magnesium is a
12.96 -> vital nutrient that's involved in many
enzymatic reactions. It is a cofactor for
18 -> numerous biological processes. Magnesium levels have been associated
21.84 -> with constipation, metabolic syndrome,
depression, hypertension, stroke, epilepsy,
27.119 -> type 2 diabetes, cardiovascular heart
disease. And studies have also found that
32.04 -> magnesium supplements have improved
symptoms in patients with migraines,
36.09 -> asthma, preeclampsia and coronary artery
disease. Magnesium is vital for bone
42.27 -> mineralization. Also by forming positive
ions, magnesium is essential to the
47.34 -> breakdown of numerous nutrients and
cellular materials. It assists in the ion
52.289 -> channel regulation as part of the active
transport of calcium and potassium
55.71 -> across cell membranes. Magnesium reduces the risk of blood clotting by reducing
60.84 -> platelet aggregation. Blood pressure is
affected by magnesium because it helps
65.549 -> to stimulate the production of
vasodilator -not gonna pronounce this
69.689 -> correctly- prostacyclin's and nitric
oxide which modulates vascular tone.
77.99 -> Adequate magnesium levels have shown to
reduce with arrhythmia's, insulin
82.53 -> resistance and cardiovascular heart
disease despite the importance of
87.75 -> adequate magnesium intake. Approximately half of Americans don't consume the
92.07 -> recommended amount of magnesium in their diets.
94.729 -> There are numerous sources of magnesium and some of them are almonds, spinach,
100.229 -> bananas and avocados. And even though
magnesium is so important, as I had just
106.17 -> listed all of those vital functions
in our body, a lot of people don't eat an
111.99 -> adequate amount. The research I found it
said approximately half of Americans but
117.09 -> I would say it's probably more than half
of the people I know eat low amounts
122.67 -> spinach they might have an occasional
banana and guacamole. But very
127.89 -> infrequently do I see people eating on
almonds or seeds, black beans things like
132.629 -> that. Magnesium deficiency can also result
136.76 -> from reduced absorption, alcoholism,
hypothyroidism, drug-related
141.35 -> malabsorption, chronic diarrhea, and
pancreatic problems. So even if someone
145.19 -> is eating an adequate amount some of
these things could create a deficiency.
149.27 -> And groups that are higher higher risk
for magnesium deficiency are people that
154.4 -> might have Crohn's or celiac disease,
regional enteritis, intestinal bypass
158.66 -> surgeries, diabetes, acidosis, chronic
kidney disease. Small reductions in
166.25 -> tissue magnesium is undetectable, so
magnesium deficiency frequently goes
171.08 -> undiagnosed. Also because the
initial symptoms of magnesium deficiency
176.87 -> are kind of vague they might appear to
be related to other things. So, testing
182.45 -> might not be done for that right away
because early symptoms are simple things
186.41 -> that include nausea, vomiting, loss of
appetite. All which could be from a number of
190.64 -> things. But when plasma magnesium
concentrations fall below normal range,
195.58 -> patients might notice things like
tremors, muscle weakness, tetany,
199.58 -> cramping, twitching and other
muscular related things. Magnesium
206.24 -> deficiency is also a known risk
factor for the development of
210.02 -> hypertension and since hypertension
increases the chance of developing
213.53 -> cardiovascular heart disease and
increases our risk of fatal instances of
218.51 -> cardiac events it really is so important
to study ways to avoid deficiency.
226.99 -> Cardiac arrhythmias have been associated
with low serum magnesium and severe
232.61 -> arrhythmias or atrial fibrillation can
lead to blood clots stroke and heart
236.39 -> failure. So just more reasons why we
really need to be on top of magnesium
242.6 -> levels in the body. As deficiency worsens,
related metabolic effects and central
248.78 -> nervous system symptoms can occur. Things such as decreased parathyroid hormones,
253.76 -> involuntary eye movements, hallucinations
confusion, irritability, restlessness and
259.609 -> even severe things like psychosis and
seizures. Also drops in serum
264.68 -> potassium and calcium can affect numerous other processes in
268.56 -> our bodies. All of the things that
potassium and calcium are responsible for.
272.55 -> Studies have also demonstrated that
there is a correlation between low serum
278.34 -> magnesium levels, urinary magnesium
secretion and high blood pressure.
284.16 -> All things that kind of give us more
direction as to where we need to
288.54 -> continue studying. We know that the
majority of the magnesium in our body is
295.41 -> actually in our bones and cells. Only 1%
of our body's magnesium is in our blood
300.12 -> serum. This makes testing serum
magnesium levels really an insufficient
306.33 -> indicator of our total magnesium. So some
of them may be deficient and their serum
312.03 -> magnesium level isn't going to
tell their doctor that. And despite the
316.56 -> vast body of research that we have
currently published regarding
320.4 -> magnesium's relationship to blood
pressure or cardiovascular heart disease,
324.5 -> serum magnesium analysis decreases the
value of their findings. So, when a study
330.63 -> that used serum magnesium level as as
a biomarker may not be as useful as we
337.02 -> once thought.
339.87 -> The propsed study that we're
trying to design here determines if
345.66 -> supplementing 350 milligrams of
magnesium daily for four weeks in adults
351.99 -> with their first reading of stage 1
hypertension, will that return their
356.82 -> blood pressure to a normal range? So,
basically what I'm trying to say is if
360.69 -> a patient comes in for the first
time with an abnormal blood pressure,
365.37 -> will four weeks of 350 milligrams daily
return their blood pressure to normal?
372.06 -> This type of study can help us find
an approach to early intervention for
377.67 -> save stage 1 hypertension. The research question is: Do adults ages
384.56 -> 35 to 60 who have a systolic blood
pressure between 140 and 159 and the
391.58 -> diastolic blood pressure between 90 and
99 show an improvement in blood pressure
397.85 -> rate with a daily 350 milligrams
supplement of powder magnesium at a
403.97 -> four-week follow-up? And my hypothesis is
that daily intake of the 350 milligrams
410.72 -> powder magnesium supplement for four
weeks will return blood pressure to a
415.13 -> normal range in patients aged 35 to 60
who have just been monitored as stage 1
421.28 -> hypertensive. A quantitative research study will be
426.57 -> completed with parallel groups of
patients ages 35 to 60 who have stage 1
431.85 -> hypertension which the criteria was, as I
had mentioned, on the last slide and will
437.34 -> mention again, for the first time at a
check-up in their general practitioners
441.24 -> office. So, in order to be considered in
the stage 1 hypertension range patients
445.83 -> have to have a systolic blood pressure
between 140 and 159 and the diastolic
450.389 -> blood pressure between 90 and 99. All of
the eligible participants are
454.98 -> individuals who in previous doctor
visits had had normal blood pressure
459.05 -> ranges all the time so they had never
once had an abnormal blood pressure reading.
464.91 -> Exclusion criteria limits
individuals with a history of kidney
470.07 -> disease, missing a piece or an entire
kidney, chronic kidney infections, cardiac
475.08 -> events, cancer, use of diuretics or
antihypertensive drugs, previous
479.91 -> instances of hypertension, digestive
disorders, smoking or alcoholism.
484.94 -> Individuals who are eligible, according
to their blood pressure rate, will be
489.03 -> asked to confirm that they do not have
any of the conditions that would exclude
493.05 -> them from this study. Their doctor will
additionally need to confirm this by
497.669 -> checking with the individuals records
and they're allowed to do that because
500.97 -> this is the their own physician. The
entire study process and some of the
506.91 -> details about the importance of this
study will be explained to the eligible
510.81 -> patients. Interested eligible individuals
will be given the consent letter to read
516.33 -> and review and are given a long time to
consider participating in the study while
521.039 -> they wait for their doctor to come into
the room. And they can take more time as
525.14 -> they need afterwards and can schedule an
appointment to come in for their initial intake.
529.92 -> If anyone at any time during the
study feels any adverse
536.31 -> reactions from the supplement at any
time they can immediately stop taking
540.36 -> it and come in to see their doctor. Completion of the study is not required
544.56 -> but anyone who does not complete it will
not have their data included in the study.
548.67 -> Participants can only miss or skip
one day throughout the length of the
553.11 -> study for their data to be included in
the final results.
557.33 -> Upon agreement to participate in the
study the patient's blood pressure will
560.99 -> be taken three times four minutes apart
and recorded. Blood pressure will be
565.91 -> taken by a registered nurse in the
doctor's office using an aneroid device.
569.269 -> An identification number which will only
be known by the patient, the doctor and
573.74 -> the nurse will be given to each patient
for recording purposes. The top of the
578.51 -> jar that they received will be labeled
with the patient's personal
581.959 -> identification number in a magic marker. Every other participant will be given
588.519 -> a jar a which has a powder magnesium
citrate and a scooper that will provide
593.44 -> them with 350 milligrams of magnesium to
be dissolved in water and consumed once
599.35 -> daily for four weeks straight. The
individuals who are not given the
603.7 -> magnesium supplement are given an
identical looking powder placebo in a
607.93 -> jar labeled B. Neither the physician
providing the jars nor the patient will
612.519 -> know whether a or b is the magnesium or
the placebo. Nightly, when the participant
618.22 -> takes the supplement they are directed
to call a toll-free number to input
622.149 -> their personal identification number to
account for taking the supplement that day.
625.959 -> And this will help ensure patient
compliance. If anyone that misses more than
631.18 -> one day throughout the duration of the
study, they will be asked to stop the study
635.74 -> and their data will not be included. Participants will receive no dietary
641.049 -> advice until the completion of the
four-week study. After the study an
644.919 -> optional free dietary counseling session
is offered. These individuals have just
649.929 -> slightly elevated blood pressure so
they're not it like a huge, major risk
653.379 -> within just a month time period of going
about their regular day-to-day lives. But,
659.799 -> of course, if a patient does not want to
complete the study, has stage 1
667.839 -> hypertension and wants to discuss with
their doctor taking medication, they are
671.529 -> obviously welcome to do so. That's up to
the patient and the doctor.
677.139 -> People who that DO choose to participate
in this study will schedule a follow-up
681.129 -> appointment with the same physician
exactly four weeks after their initial
684.969 -> intake. At their four-week follow up the
intake nurse will again use an aneroid
689.349 -> device to monitor blood pressure
three times
692.889 -> four minutes apart to be reported next
to their identification number.
699.039 -> Here is the sample of what the sheet will look like for individuals that get the jar A
706.209 -> The first person will get jar a
and the date will be recorded just to
711.429 -> make sure that at the follow-up is
exactly four weeks later. And the nurse
715.389 -> will just do three blood pressure
readings under intake one and intake two
720.189 -> and intake three. Then at the four-week follow up they'll do the same thing and then
724.239 -> during analysis the averages will be
done. And as you can see here every other
728.47 -> person will get jar B. That's two four
six and so on and so forth. And these
734.829 -> data sheets will be kept in manila files
labeled A and B. They're going to be kept
738.909 -> in a locked cabinet along with the jars
of supplements, the aneroid device used
742.989 -> to monitor the subjects blood pressure,
and the writing utensils needed to
746.47 -> record the data. So the same aneroid
device will be used for every one and
750.299 -> all the materials will be there in that
locked cabinet. The key to the cabinet is
754.749 -> going to stay in the participating
doctor's private office and a location
758.079 -> only known to them and this will ensure
that that information just stays private
762.899 -> even though it's just identification
numbers no names. The patient is responsible
770.07 -> for disposing of their supplement jar
that was labeled with their identification
773.19 -> number on it, at the end of the study. And
there will be no way to track the
777.54 -> patients to the data, besides by the date
of their intake appointment but that
781.709 -> would require someone to have access to
the patient's medical records, which
784.98 -> would only be their doctor, who should
already know what their blood pressure is.
788.16 -> Now, the statistical analysis part is
not my strong suit but I believe I've
795 -> worked it out here that to calculate the
sample size needed for this study using
799.74 -> g-power software and a priori
statistical analysis was done using a
803.97 -> t-test involving the difference between
two independent means. Using an error
808.529 -> rate of 0.05, a power of 0.8, and a medium
effect size of 0.5, the total sample size
815.399 -> I determined was 128. Which seemed a
little low to me, so I may have to rework
820.11 -> that. But this means that sixty-four
people have to complete the study taking
824.97 -> jar A and 64 will need to take jar B.
830.42 -> The data will be entered into a
Microsoft Excel Excel spreadsheet and
834.54 -> then rechecked by another individual to
ensure the data was properly transferred.
837.959 -> And this is all identification numbers
so nothing can be tracked to the
841.769 -> participants. And then using the simple
Excel formula for averaging, the blood
846.839 -> pressure rates will be calculated for
each individual's average for their
849.959 -> intake and their follow-up. In Excel
we'll also be used to do a means
853.709 -> comparison of the two data sets to get
the central tendency and to determine if
858.449 -> there is a relationship between the
magnesium supplement and a decrease in
862.17 -> blood pressure. Using the standard
deviation formula in Excel the
866.819 -> variability of the datasets will be
observed. The standard deviation will be
870.75 -> divided by the square root of the sample
size to determine the standard error and
874.38 -> measure the precision of the results. Also in g-power a post-hoc calculation
879.06 -> will be done to determine the power of
the study. And here are my references.
885.51 -> And I thank you very much for listening! And I hope that you have a great day!
Source: https://www.youtube.com/watch?v=VZdZALwycd4