REJUVENATION RESEARCH Volume 11, Number 1, 2008 © Mary Ann Liebert, Inc. DOI: 10.1089/rej.2007.0583 Hypermagnesemia Predicts Mortality in Elderly with Congestive Heart Disease: Relationship with Laxative and Antacid Use Graziamaria Corbi, 1,2 Domenico Acanfora, 1 Gian Luca Iannuzzi, 1 Giancarlo Longobardi, 1 Francesco Cacciatore, 1 Giuseppe Furgi, 1 Amelia Filippelli, 3 Giuseppe Rengo, 1 Dario Leosco, 4 and Nicola Ferrara 1,2 ABSTRACT The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure (CHF) admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients  65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their de- mographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypo- magnesemia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hyper- magnesemia in respect to normomagnesemia group, except for slightly higher levels of crea- tininemia (1.35  0.61 vs. 1.13  0.55 mg/dL, respectively; p  0.02), greater disability (lost ADL, 2.69  1.57 vs. 2.15  1.56, respectively; p  0.05), more mortality for CHF (32.6 vs. 48.3%; p  0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p  0.0001). Pa- tients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32  15.93 vs. 22.46  16.16 months; p  0.05), and this find- ing remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal fail- ure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs. 1 INTRODUCTION M AGNESIUM CONCENTRATION has been con- sidered a prognostic indicator of mor- bidity and short-term mortality in patients with cardiovascular diseases and congestive heart failure (CHF). 1–5 Total cardiac magnesium con- tent is reduced in CHF, and it is unclear 1 Rehabilitative Cardiology Unit of S. Maugeri Foundation, Scientific Institute of Telese/Campoli, IRCCS, Telese Terme, Italy. 2 Department of Health Sciences, Faculty of Medicine, University of Molise, Campobasso, Italy. 3 Department of Experimental Medicine, Section of Pharmacology Leonardo Donatelli, Center of Pharmacosurveil- lance and Pharmacoepidemiology, Second University of Naples, Naples, Italy. 4 Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy.