Serum magnesium, phosphorus, and calcium levels and subclinical calcific aortic valve disease: A population-based study

Atherosclerosis. 2018 Jun;273:145-152. doi: 10.1016/j.atherosclerosis.2018.03.035. Epub 2018 Mar 22.


Background and aims: Calcific aortic valve disease (CAVD) is the most common valve disease. Although micronutrients are known to contribute to cardiovascular disease, the relationship with CAVD remains poorly evaluated. We examined the association of serum levels of magnesium, phosphorus, and calcium with prevalence, incidence, and progression of aortic valve calcification (AVC).

Methods: We conducted a prospective study in a population-based sample of Japanese men aged 40-79 years without known cardiovascular disease and chronic kidney disease at baseline, and quantified AVC from serial computed tomographic images with the Agatston method.

Results: Of 938 participants at baseline (mean age, 63.7 ± 9.9 years), AVC prevalence was observed in 173 (18.4%). Of 596 participants without baseline AVC at follow-up (median duration, 5.1 years), AVC incidence was observed in 138 (23.2%). After adjustment for demographics, behaviors and cardiovascular risk factors, relative risks (95% confidence intervals) in the highest versus lowest categories of serum magnesium, phosphorus, and calcium were 0.62 (0.44-0.86), 1.45 (1.02-2.04), and 1.43 (0.95-2.15), respectively, for AVC prevalence and 0.62 (0.42-0.92), 1.93 (1.28-2.91), and 1.09 (0.77-1.55), respectively, for AVC incidence. Their linear trends of serum magnesium and phosphorus were also all statistically significant. Of 131 participants with baseline AVC, there was no association of any serum micronutrients with AVC progression.

Conclusions: Serum magnesium was inversely associated, while serum phosphorus was positively associated with AVC prevalence and incidence, suggesting that these serum micronutrients may be potential candidates for risk prediction or prevention of CAVD, and warranting further studies.

Keywords: Aortic valve disease; Calcification; Epidemiology; Magnesium; Phosphorus; Prospective study.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / blood*
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / epidemiology*
  • Calcinosis / blood*
  • Calcinosis / diagnosis
  • Calcinosis / epidemiology*
  • Calcium / blood*
  • Disease Progression
  • Humans
  • Incidence
  • Magnesium / blood*
  • Male
  • Middle Aged
  • Phosphorus / blood*
  • Prevalence
  • Prospective Studies


  • Phosphorus
  • Magnesium
  • Calcium

Supplementary concepts

  • Aortic Valve, Calcification of