Nifedipine chemical structure
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Adalat

Nifedipine (brand name Adalat and Procardia) is a dihydropyridine calcium channel blocker. Its main uses are in angina pectoris (especially Prinzmetal angina) and hypertension, although a large number of other uses have recently been found for this agent, such as Raynaud's phenomenon, premature labor, and painful spasms of the esophagus in cancer patients.

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The mineral that could have saved 4 million women - Letters to the Editor
From Townsend Letter for Doctors and Patients, 7/1/03

Editor:

Modern medicine has made a remarkable admission. Its failure to utilize a simple, inexpensive intravenous mineral drip might have saved the lives of millions of women over the past century. Modern medicine knew about the cure since 1906. [New England Journal Medicine 333: 201-05, 1995]

Around 210 million women become pregnant annually around the world and every minute a woman dies in pregnancy or childbirth, with a quarter of these deaths due to a condition called pre-eclampsia which can lead to the more severe and mortal condition called eclampsia. Women may develop high blood pressure during pregnancy (pre-eclampsia) and during or prior to birth may experience life-threatening seizures (eclampsia). About 5-10 percent of women in their first pregnancy develop pre-eclampsia.

Over the past century, drugs rather than minerals have been employed to treat eclampsia, Diazepam (Valium) in 1968 and then phenytoin (Dilantin) in 1987. During the period 1905 to 1987 an estimated 42 million women may have undergone eclamptic convulsion and possibly 4 million died. The modern therapy for eclampsia now includes calcium-blocking drugs and a host of anti-hypertensive agents. Drugs may reduce the risk of severe high blood pressure, but not the overall rate of hypertension nor the risk of eclampsia. [The Cochrane Library, Issue 2, 2002] Yet the anticonvulsant drugs continue to be employed with little reliable evidence that they work.

Finally, a study of 10,141 women in 33 countries has shown beyond a "reasonable doubt" that intravenous magnesium reduces the risks of eclampsia among women with pre-eclampsia. The relative risk of eclampsia was reduced by 58% and the mortality rate nearly cut in half among women receiving magnesium compared to those who receive a saline drip. The authors of the study concluded that "magnesium sulfate is remarkably effective at reducing the risk of eclampsia." [The Lancet 359: 1877-90, June 1, 2002]

Not The First Time

This wasn't the first study to conclusively show magnesium sulfate is a remedy for eclampsia. In a 1995 study heralded as the most important obstetric trial of the 20th century, magnesium sulfate was found to be the most effective approach to controlling convulsions during childbirth. [British Medical Journal 311: 702-03, 1995] By 1998, data from numerous studies had been analyzed and it was known that magnesium was superior to any anticonvulsant drugs. [Cochrane Review 2002] This evidence still didn't convince most obstetrical doctors.

Seven years after the report showing magnesium reduces the risk of mortality from eclampsia, a report endorsed by the World Health Organization (WHO), UNICEF and the World Bank, magnesium sulfate is still not available to millions of women worldwide. British medical researchers are pleading with the World Bank and WHO to fund and disseminate treatment kits. [The Lancet 359: June 1, 2002]

Clues Were There

It wasn't as if physicians had no clues as to the cause of eclampsia. The worldwide mortality rates from eclampsia vary widely from country to country. The mortality rate from eclampsia ranges from 0 to 13.9%. [European Society Cardiology 21st Annual Congress, Sept. 1, 1999] So there are obviously some modifiable factors involved in the development of eclampsia among pregnant females. Pre-eclampsia and eclampsia are the most important causes of death during pregnancy in the United Kingdom, USA and Nordic countries, nations that consume the most calcium-rich dairy products. Calcium and magnesium must be maintained in a proper ratio to maintain proper muscle tone and prevent convulsive muscle spasms. Furthermore, estrogen and progesterone levels, which increase as a pregnancy advances, elevate the body's demand for magnesium. (Journal American College 0/Nutrition 12:442-58, 1993] Magnesium is a natural calcium blocker. [American Journal Medicine 96: 63-76, 1994]

Magnesium Shunned for Heart Disease Too

This isn't the first time magnesium has been shunned in favor of prescription drugs. In the 1990s a preliminary report showed that intravenous magnesium reduced mortality rates following a heart attack. This was apparently perceived as a threat to the sale of calcium-blocking drugs used for the same purpose. Medical researchers, financially backed by a pharmaceutical company that produces calcium-blocker drugs, deliberately chose to use an excessive dose of intravenous magnesium to prove it was of no value during the post-heart attack period. [Townsend Letter for Doctors, October 1998] The sale of calcium-blockers never faltered. There are more than 64 million annual prescriptions for calcium blocking drugs (Procardia, Cardizem, Norvasc, Verpamil, Adalat, Dilacor, Verelan, Calan), with sales exceeding $2.5 billion. [American Druggist 1997]

Magnesium May Prevent Sudden-Death Heart Attacks

Magnesium is not limited to treating heart disease after a heart attack. A shortage of dietary magnesium has been repeatedly shown to be associated with an increased risk of sudden-death heart attack. Unequivocally, a shortage of magnesium from the American diet, in particular the absence or shortage of magnesium in drinking water, is directly related to sudden-death heart attack. [Epidemiology 10: 31-36, 1999; Heart 82: 455-60,1999; American Journal Epidemiology 143: 456-62, 19961 Out of 750,000 heart attacks in the USA annually, an estimated 340,000 deaths occur within one hour of a heart attack. [Journal Nutrition Health Aging 5: 17378, 2001]

One study showed the relative risk of sudden-death heart attack is more than 1.5 times higher among adults who consume on average 105 milligrams of magnesium a day compared to adults who consume 233 milligrams a day. [Magnesium Trace Element Research 9: 143-51,1990]

Recently researchers reported on the effects of slowly withdrawing magnesium from the diet of postmenopausal women. Women began to exhibit abnormal heart rhythms as circulating magnesium levels declined. [American Journal Clinical Nutrition 75: 550-54, 2002]

Of the minerals removed during water softening, magnesium is the only mineral found to be deficient in the heart muscle of sudden-death heart attack victims. [Science 208: 198-200, 1980] In an animal experiment, no rodents experienced a sudden-death heart attack when magnesium levels were adequate, whereas 4 of 11 rodents with low magnesium levels experienced a sudden lethal heart muscle spasm. [Journal American Collage Cardiology 27: 1771-76, 1996]

For comparison, there are about 50,000 tobacco-related deaths per year in the USA and consequently massive smoking-cessation efforts are undertaken. There are more than 200,000 to 300,000 avoidable sudden-death heart attacks that could be prevented by the provision of an inexpensive mineral; yet public health authorities do nothing to stop the problem. This amounts to over 500 needless deaths per day in the USA.

The current approach to cardiovascular disease is to reduce circulating cholesterol levels which has been shown to reduce the incidence of heart attacks but has not reduced mortality rates. Sudden fatal heart failure may be related to magnesium deficiency rather than high cholesterol levels. [Medical Hypotheses 43: 187-92, 1994]

Widespread Dietary Deficiency

A 1994 Gallup poll found that 72% of Americans don't consume sufficient amounts of magnesium. The widespread consumption of processed foods has led to a progressive decline in dietary magnesium. While nuts and green leafy vegetables are good sources of magnesium, the shortage of magnesium in the American diet, about 200-300 milligrams per day, is not likely to be made up through foods alone.

Supplementation Advised

Only universal magnesium supplementation is likely to make up for such a widespread mineral deficiency. Foods cannot easily be fortified with magnesium because it is a bulky mineral that would alter the consistency and taste of flour and foods. Magnesium cannot be added to tap water because it would erode piping. Either magnesium pills or magnesium added to bottled water would make up for this mineral deficiency. Currently, only 5 major brands of bottled water provide a desirable measure of more than 75 milligrams of magnesium per liter and only one brand has a ratio of magnesium that exceeds that of calcium.

Blood tests for magnesium are notoriously inaccurate. Only 1 percent of the total body magnesium pool exists outside of living cells. So blood serum levels are notoriously inaccurate. [Clin Chem Lab Med 37: 1011-33, 1999]. Only red-blood cell magnesium levels accurately determine the risk for pre-eclampsia and/or magnesium deficiency, but this test is not commonly performed in laboratories. [American Journal Hypertension 13: 765-69, 2000]

A bias against the use of intravenous magnesium sulfate by modern medicine has taken a terrible toll on humankind. Magnesium sulfate, also known as Epsom salt, is not absorbed orally and attracts water in the colon and would thus act as a laxative. So Epsom salts are not recommended orally. Magnesium pills are recommended (200-400 milligrams per day). Magnesium has been called "The Forgotten Mineral" and the "5-Cent Miracle Tablet" by medical researchers. Numerous researchers have reported that the provision of this mineral to the population at large would greatly diminish the incidence of kidney stones (1 in 11 Americans), calcified mitral heart valve (1 in 12 Americans), premenstrual tension, constipation, miscarriages, stillbirths, strokes, diabetes, thyroid failure, asthma, chronic eyelid twitch (blepharospasm), brittle bones, chronic migraines, muscle spasms and anxiety reactions. [Pediatric Asthma, Allergy Immunology 5: 273-79; Journal Bone Mineral Research 13: 749-58, 1998; Magnesium 5: 1-8, 1986; Medi cal Hypotheses 43: 187-92, 1994] That's a lot of health benefits for a nickel. Sufficient provision of magnesium in the American population would likely reduce health care costs by billions of dollars.

Bill Sardi

BSardi@aol.com

Bill Sardi [send him mail] is president of Knowledge of Health, Inc., San Dimas, California. His latest book is In Search of the World's Best Water, Here & Now Books.

Copyright (c) 2002 Bill Sardi word of Knowledge Agency, San Dimas, California. Not for commercial reproduction without permission of the author.

COPYRIGHT 2003 The Townsend Letter Group
COPYRIGHT 2003 Gale Group

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