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What are the effects of potassium and magnesium on the heart?
Many people suffer from a mineral deficiency without knowing it. If there is a deficiency in potassium and magnesium, but this can have a dramatic impact on our health, experts from the German Heart Foundation warn in a recent announcement. Due to the increased risk, potassium and magnesium values should be checked regularly by a doctor, particularly in the case of cardiac arrhythmias, cardiac insufficiency, kidney diseases and taking certain heart medications.
A deficiency in potassium and magnesium favors atrial fibrillation and other cardiac arrhythmias, according to the experts of the German Heart Foundation. It is therefore necessary to counteract a corresponding deficiency by adding potassium and magnesium. However, many sufferers are not aware that their mineral values are too low. Regular medical checks would be required here, in particular for certain risk groups.
Minerals with a decisive influence on heart function
Potassium and magnesium are important for normal heart function because they electrically stabilize the heart cells, explains the German Heart Foundation. The minerals form electrical impulses in the heart cells and are of crucial importance for the signal transmission between the cells. "Potassium and magnesium only have a stabilizing effect if their concentration is within the normal range," emphasizes Professor Dr. med. Andreas Götte from the Scientific Advisory Board of the German Heart Foundation. The normal range for potassium is between 3.6 and 4.8 mmol / l, for magnesium between 0.7 and 1.05 mmol / l - with minor deviations depending on the laboratory method.
Increased susceptibility to arrhythmia
If the value falls below the lower limit, potassium deficiency (hypokalaemia) and magnesium deficiency (hypomagnesaemia) in the cells lead to increased excitability of the cell membrane, which means that extra beats of the heart (extrasystoles) are formed, the experts explain. The heart becomes more susceptible to rhythm disturbances in the atria (atrial fibrillation) and the heart chambers. In the worst case, extreme magnesium deficiency can promote life-threatening ventricular fibrillation.
Symptoms of potassium and magnesium deficiency
The German Heart Foundation names symptoms such as fatigue, muscle weakness and constipation as further symptoms of potassium deficiency. Magnesium deficiency in turn can lead to symptoms such as muscle tremors, muscle weakness and muscle cramps.
When should potassium and magnesium levels be checked?
According to the experts, regular checks of the concentration of potassium and magnesium in the blood are particularly appropriate for cardiac arrhythmias, cardiac insufficiency, kidney diseases and certain heart and hypertension medications to protect against possible complications, including atrial fibrillation and life-threatening rhythm disorders such as ventricular fibrillation.
In the case of cardiac arrhythmias, it is also important to set the potassium and magnesium values “highly normal” (eg to a potassium value of 4.4 mmol / l and a magnesium value of 0.9 mmol / l). In some cases the cardiac arrhythmia can be remedied, but often other causes have to be looked for and the rhythm disturbance itself has to be treated, explains Professor Götte.
Diet with a significant impact
To compensate for the potassium and magnesium deficiency, a changed diet can make a significant contribution. Normally, the body receives enough potassium and magnesium from food. Dried apricots and dried bananas and vegetables such as potatoes, legumes, peas, white beans and lentils are good sources of potassium, according to Professor Götte. Good suppliers of magnesium are dried fruit, beans, lentils, grain products and nuts.
Causes of mineral deficiency
However, according to the expert, kidney dysfunction, diarrhea, excessive use of laxatives, vomiting, fever and excessive sweating can also contribute to a significant loss of potassium and magnesium. For example, taking diuretics that drive water can accelerate the loss of electrolytes in patients with heart failure. Other factors that can contribute to the drop in potassium and magnesium levels include summer heat, excessive alcohol consumption, diabetes and biliary tract diseases.
Warning of unauthorized magnesium and potassium intake
Although the magnesium or potassium deficiency should be compensated for due to the increased susceptibility of the heart muscle cells to rhythm disturbances, the experts warn against taking potassium and magnesium preparations without consulting a doctor. "Basically, potassium and magnesium should only be used if a deficiency has been found in the laboratory," emphasizes Professor Götte. If the standard values cannot be achieved with a diet rich in magnesium and potassium, medication should not be used as a food supplement, the expert continues.
How is the deficiency remedied?
If potassium is deficient, potassium is best used as potassium chloride (40 mmol per day) and if there is magnesium deficiency, magnesium aspartate or magnesium citrate (10 mmol per day). Professor Götte further explains that potassium deficiency can only be effectively compensated if the magnesium values are within the normal range. A magnesium deficiency increases the symptoms of a potassium deficiency.
Increased values are also harmful
Regarding the reverse variant - an excess of the two minerals - the German Heart Foundation reports that an excessively high magnesium level is rather rare, whereas an excessively high potassium level is significantly more common. This has the consequence that the excitability of the pacemaker and heart muscle cells decreases, so that the heart beats more slowly. With extremely high potassium levels, the slowdown can go so far that the heart no longer beats and cardiac arrest occurs.
What can lead to excessive potassium and magnesium levels?
The German Heart Foundation cites acute kidney weakness as the cause of an excessively high concentration of potassium in the blood, but also medications that are used to treat high blood pressure and heart weakness, such as ACE inhibitors, sartans and, above all, aldosterone antagonists. Potassium-sparing diuretics can also increase potassium levels. Therefore, potassium levels and kidney function should be checked regularly in these cases. If the levels of potassium and magnesium are life-threateningly excessive, the administration of diuretics or dialysis treatment can lower the potassium or magnesium levels, for example.
Which medication should be used for monitoring?
According to the German Heart Foundation, monitoring of potassium levels and kidney function is strongly advised when taking the following medicines:
- Diuretics (drainage agents),
- ACE inhibitors,
- Sartane or ARNI (valsartan / sacubitril),
- Aldosterone antagonists,
- potassium-sparing diuretics (drainage agents),
- Digitalis preparations (digoxin and digitoxin).
The controls should be carried out before the start of therapy, before changing the dosage and in the following two weeks and then every six months. Monitoring potassium and magnesium levels is particularly important for heart failure patients. Because with them a cardiac arrhythmia can lead to a dangerous deterioration of the weakness of the heart, in the worst case to heart failure, warns the German Heart Foundation. (fp)