Macro- and micronutrients in patients with congestive heart failure, particularly African-Americans
Authors Kevin P Newman, Syamal K Bhattacharya, Ahmad Munir, Richard C Davis, Judith E Soberman, et al
Published 15 November 2007 Volume 2007:3(5) Pages 743—747
Kevin P Newman1, Syamal K Bhattacharya1,2, Ahmad Munir1, Richard C Davis1, Judith E Soberman1, Kodangudi B Ramanathan1
1Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA 2Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
Abstract: Not all patients with heart failure, defined as a reduced ejection fraction, will have an activation of the RAAS, salt and water retention, or the congestive heart failure (CHF) syndrome. Beyond this cardiorenal perspective, CHF is accompanied by a systemic illness that includes oxidative stress, a proinflammatory phenotype, and a wasting of soft tissues and bone. A dyshomeostasis of calcium, magnesium, zinc, selenium, and vitamin D contribute to the appearance of oxidative stress and to compromised endogenous defenses that combat it. A propensity for hypovitaminosis D, given that melanin is a natural sunscreen, and for secondary hyperparathyroidism in African-Americans make them more susceptible to these systemic manifestations of CHF—a situation which is further threatened by the calcium and magnesium wasting that accompanies the secondary aldosteronism of CHF and the use of loop diuretics.
Keywords: African-Americans, heart failure, calcium, magnesium, zinc, selenium