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Correlation of hypomagnesemia with the onset of cyclosporine-associated hypertension in marrow transplant patients.

Cyclosporine is known to cause hypertension, and we have recently reported that it causes hypomagnesemia and renal magnesium wasting in marrow transplant recipients. We performed a case-control study to ask whether hypomagnesemia might be related to this form of drug-induced hypertension. The charts of 188 patients treated with cyclosporine were evaluated for the development of hypertension. The 32 patients who became hypertensive were age, sex, and disease-matched with 32 cyclosporine-treated controls. Baseline serum Mg levels were normal in both groups. However at the time of development of hypertension, the hypertensive patients had a mean (+/- SD) Mg of 1.22 +/- 0.20 mEq/L versus controls 1.40 +/- 0.33 mEq/L (P less than 0.01). Serum calcium, albumin, creatinine, potassium, and cyclosporine concentrations were not different between the two groups. This study may indicate that hypertension and hypomagnesemia are coincident toxicities in cyclosporine-treated patients. Alternatively, our data support the hypothesis that acquired derangements in magnesium metabolism may contribute to the development of hypertension. Magnesium replacement may prove beneficial in the treatment and/or prevention of cyclosporine-associated hypertension.