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Magnesium in Hypertension Prevention and Control

September 2004

By Jay S. Cohen, MD

LE Magazine September 2004
Magnesium in Hypertension Prevention and Control
By Jay S. Cohen, MD

High blood pressure is an even stronger predictor of cardiovascular risk than high cholesterol. Scientific studies directly correlate high blood pressure with decreased longevity. Yet most mainstream physicians and their patients ignore this risk until life-threatening hypertension has already developed.

A well-established body of research indicates that nutrients such as magnesium are highly effective in treating and—even more importantly—preventing high blood pressure. Because this metallic element is not plentiful in foods, magnesium supplementation may be effective in both prevent ing and controlling high blood pressure. Learn why you should be concerned about high blood pressure—whether you have it yet or not.

Fifty million Americans have high blood pressure. If you are not one of them, you likely will be eventually. As New York Times health columnist Jane Brody wrote:

“Americans now 55 or over face a 90% chance of developing high blood pressure, or hypertension, a major risk factor for heart attacks, strokes, congestive heart failure, circulatory failure, kidney disease, and loss of vision.”1

Hypertension expert Norman Kaplan, MD, agrees, writing that “Most people will develop hypertension during their lifetime.”2 In fact, 800 million people—or about 20% of the Earth’s adult population—already have high blood pressure. This is bad news because hypertension leads directly to heart disease, kidney disease, strokes, and other major health disorders. Conn’s Current Therapy, a highly respected medical reference, defines how hypertension greatly reduces longevity:

“A 35-year-old man with an arterial pressure of 130/90 will die 4 years earlier than another 35-year-old man with the same medical background but with normal pressure. If his pressure is 140/90, he will die 9 years earlier, and if it’s 150/100, he will die 17 years earlier.”3

To put it in perspective, Mark Houston, MD, a nationally recognized expert on hypertension, once asked an audience of health care practitioners, “If you have elevated cholesterol, diabetes, and hypertension, which should you treat first?” Most picked diabetes, and others chose elevated cholesterol, but the correct answer is hypertension. Why? Because high blood pressure is a much stronger indicator of cardiovascular risk than high cholesterol. The damage to blood vessels caused by high blood pressure leads to hundreds of thousands of heart attacks and strokes each year. Moreover, people with high blood pressure have a much greater risk of developing adult-onset diabetes, and most people with diabetes sustain their greatest harm from the hypertension that frequently accompanies it.

This is why preventing hypertension is so important to maintaining health and prolonging longevity.

The Importance of Prevention
All experts agree on the importance of preventing high blood pressure. The Joint National Committee on the Prevention, Detection, Eval-uation, and Treatment of High Blood Pressure, a widely recognized expert panel of hypertension specialists, advises: “Before considering the active treatment of hypertension, the even greater need for prevention of disease should be recognized.”4 Yet mainstream medical doctors are usually content to wait for high blood pressure to develop in their patients and then treat it. Few doctors actively advise patients about how to prevent the disorder from occurring in the first place.

This treatment approach is not very effective. Of the 50 million Americans with hypertension, only about one-half are being treated, and only one-half of those are being treated adequately.


This table lists the levels of hypertension associated with different blood pressure readings. Except for Stage 2 hypertension, experts suggest that hypertension should be diagnosed only after at least two elevated blood pressure readings have been taken during different office visits. If your systolic and diastolic readings fall into different categories, the higher category defines your blood pressure classification. These classifications do not apply if you are taking antihypertensive drugs or are acutely ill.


Systolic Blood Pressure
(mm Hg)

Diastolic Blood Pressure
(mm Hg)


less than 120

less than 80




Stage 1 hypertension



Stage 2 hypertension

160 or higher

100 or higher

Adapted from the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 2003.5

Prevention is even more important today because a blood pressure of 120/80 mm Hg (systolic/diastolic) is not good enough anymore (see Table 1). The most recent report of the Joint National Committee, published in the Journal of the American Medical Association in 2003, warned:

“The risk of cardiovascular disease, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg.”5

Thus it is vitally important to do what you can to keep your blood pressure low instead of waiting for it to creep up over the years. It is especially important to be proactive because many people have a genetic tendency toward hypertension. Even if you have such a tendency, it does not mean you are powerless. As with predispositions toward developing diabetes or elevated cholesterol, much can be done to prevent hypertension from occurring or to modify its severity if it does occur.

How Lifestyle Affects Blood Pressure
Many factors contribute to the development of hypertension, and lifestyle choices play a central role. Maintaining a healthy weight is very important. Extra pounds mean extra work for the heart, which must exert additional pressure to push the blood through the extra mile of blood vessels that come with each pound of excess fat.

A healthy diet can have a major impact on your blood pressure. Studies have shown that the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes poultry, fish, fruits, vegetables, whole grains, lowfat dairy products, and nuts, can reduce blood pressure as much as some prescription drugs.6

Regular exercise and stress reduction also help keep blood pressure normal. Tobacco and stimulant drugs should be avoided, as these substances boost blood pressure and can injure the sensitive endothelium that lines the blood vessels.

Caffeinated beverages are a controversial topic among hypertension specialists. Caffeine appears to raise the blood pressure of some people but not others. Caffeine certainly does not appear to help control blood pressure and thus probably should be avoided.

Similarly, some people’s hypertension is sensitive to salt, meaning that a high or even moderate salt intake will raise their blood pressure. Other people are not sensitive to salt. Nevertheless, experts generally recommend moderation in the use of salt.

Natural Supplements vs. Prescription Drugs
The list of supplements that can help lower blood pressure is lengthy, and includes coenzyme Q10, essential fatty acids, fiber, garlic, lipoic acid, hawthorn, magnesium, N-acetylcysteine, taurine, and vitamins B6 and C, among others. Some of these substances are more useful than others; some are backed by considerable scientific study, while others are not.

Patients are not likely to hear about any of these natural therapies from a mainstream physician, though practitioners of alternative or integrative medicine regularly recommend these supplements to their patients. Unfortunately, the drug industry dominates the information that most mainstream doctors receive, so that pharmaceuticals become the primary and often only option prescribed for high blood pressure. The top-selling antihypertensive drugs are costly, however, and all come with potential side effects that may include fatigue, sedation, dry mouth, cough, dizziness, headache, nausea, diarrhea, constipation, rash, itching, flushing, swollen legs or ankles, depression, sexual dysfunctions, and metabolic imbalances. Because of these side effects, half of those who take antihypertensive medications eventually quit taking them, usually within three months of starting treatment.5,7

Moreover, even when they lower blood pressure, prescription drugs do not eliminate one’s risk entirely. People with controlled hypertension still have a higher risk of heart attack and stroke than those who have the same blood pressure but never developed hypertension in the first place. Why is this? Mainstream medicine does not have the answer. One explanation is that while drugs can be effective in blocking some of the factors that cause elevated blood pressure, these medications do nothing to address the intracellular imbalances that lead to the development of hypertension.

In other words, mainstream medicine treats the symptoms of hypertension but does not address the underlying causes. Because nutritional imbalances and other deficits remain, some of the risk remains as well.