1024 American Journal of Hypertension 28(8) August 2015 ORIGINAL ARTICLE According to reports by the World Health Organization, cardiovascular diseases are the main cause of death world- wide, 1 and high blood pressure (BP) is the most important risk factor for the development of cardiovascular disease. 2 In the year 2003, Te Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure introduced the category of prehypertension (preHTN), which included systolic BP (SBP) values between 120 and 139 mm Hg and/or diastolic BP (DBP) values between 80 and 89 mm Hg. Tis condition clearly increases the risk of developing hypertension and cardiovascular morbidity. 3 Several studies conducted worldwide have reported the prevalence of preHTN in adults; the results are very vari- able, from 14.5% in Turkey 4 to 53.9% in Brazil. 5 In México, reports regarding the prevalence of preHTN are scarce and regional. Te results range from 26.5% in Chilpancingo, Gro., 6 33.8% in Veracruz, Ver., 7 to 34.8% in the general pop- ulation of Mexico City. 8 Given that magnesium is involved in tone modulation and vascular smooth muscle reactivity, reduction of angiotensin II action, inhibition of norepinephrine release, and acts as a calcium antagonist, 9 it is possible that magnesium plays an important role in the pathogenesis of high BP. Te results from epidemiological and interventional studies suggest that low serum magnesium levels may play a modest role in the development of hypertension 10 and that oral magnesium intake and magnesium supplementation may play a role in BP regulation in hypertensive individuals. 11–13 However, data about the role of magnesium in the pathogenesis of pre- HTN are scarce. 14 Tis issue could have a public health importance because a substantial number of the US population fails to consume an adequate amount of magnesium in their diet. 15 Dietary Prevalence of Prehypertension in Mexico and Its Association With Hypomagnesemia Mariana Rodríguez-Ramírez, 1 Luis E. Simental-Mendía, 1 Manuel González-Ortiz, 1,2 Esperanza Martínez- Abundis, 1,2 Agustín Madero, 1 Olga Brito-Zurita, 1 Ricardo Pérez-Fuentes, 1 Cristina Revilla-Monsalve, 1 Sergio Islas-Andrade, 1 Martha Rodríguez-Morán, 1 and Fernando Guerrero-Romero 1 BACKGROUND Prehypertension (preHTN) increases the risk of developing hyperten- sion. The objectives of this study were to estimate the prevalence of preHTN in the Mexican adult population and evaluate the association between hypomagnesemia and preHTN. METHODS This study was a 2-phase, population-based study. In the frst phase, 4,272 Mexican adults (aged 20–65 years) were enrolled to determine the prevalence of preHTN. In the second phase, a cross-sectional analysis was performed to evaluate the association between hypomagnesemia and preHTN. The exclusion criteria were chronic diarrhea, malignancy, hepatic and renal diseases, chronic infammatory disease, and the intake of mag- nesium supplements. PreHTN was defned as a systolic blood pressure (BP) of 120–139 mm Hg and/or diastolic BP of 80–89 mm Hg, and hypomagne- semia was defned as a serum magnesium concentration <1.8 mg/dl. RESULTS The prevalence of preHTN was 37.5% (95% confidence interval (CI): 36.0–39.0): 46.7% were men (95% CI: 44.1–49.4) and 33.2% (95% CI: 31.5–5.0) were women. The serum magnesium data were avail- able for 921 participants. Hypomagnesemia was identified in 276 (30.0%; 95% CI: 27.1–33.0) subjects; of them, 176 (63.8%; 95% CI: 58.3–69.6) had preHTN. Individuals with preHTN exhibited lower magnesium levels than individuals without preHTN (1.78 ± 0.36 vs. 1.95 ± 0.37, P < 0.0005). A multiple logistic regression analysis (adjusted for age, sex, smoking, body mass index, waist circumfer- ence, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides levels) indicated a significant asso- ciation between hypomagnesemia and preHTN (odds ratio = 1.78; 95% CI: 1.5–4.0, P < 0.0005). CONCLUSIONS The prevalence of preHTN in the Mexican population is 37.5%, and hypomagnesemia is strongly associated with preHTN. Keywords: blood pressure; hypertension; magnesium; Mexico; prehy- pertension; prevalence. doi:10.1093/ajh/hpu293 Correspondence: Fernando Guerrero-Romero (guerrero.romero@gmail. com). Initially submitted September 5, 2014; date of frst revision October 7, 2014; accepted for publication December 15, 2014; online publication January 23, 2015. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com 1 The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México; 2 Institute of Experimental and Clinical Therapeutics, Department of Physiology, Health Science University Center, University of Guadalajara, Guadalajara, Mexico. Downloaded from https://academic.oup.com/ajh/article-abstract/28/8/1024/2743416 by guest on 09 February 2019