Serum Magnesium and Calcium Imbalance and Hypertension Among Adults in Southeastern Nigeria: A Comparative Study

Magnesium and calcium are important regulators of vascular function, yet evidence on their imbalance among hypertensive adults in Southeastern Nigeria remains limited. This study assessed the prevalence and distribution of serum magnesium and calcium imbalance among treated hypertensive, treatment-naïve hypertensive and normotensive adults. This comparative baseline analysis included 135 adults aged 30–65 years, with 45 participants in each group. Participants were recruited from selected healthcare facilities in Nnewi North and Ekwusigo Local Government Areas, Anambra State. Serum magnesium and calcium were determined using Xylidyl Blue and o-cresolphthalein complexone methods, respectively. Categorical variables were compared using chi-square tests, while continuous variables were analysed using one-way ANOVA. Cramér’s V quantified association strength. Hypertensive participants were older and had greater body weight and BMI than normotensive controls (all p<0.001), whereas sex distribution and height were comparable. Magnesium imbalance occurred in 22.2% of treated hypertensives, 33.3% of treatment-naïve hypertensives and 0% of normotensive controls (χ²=17.18, p=0.00019; Cramér’s V=0.36). Calcium imbalance occurred in 17.8%, 22.2% and 0%, respectively (χ²=10.77, p=0.0046; Cramér’s V=0.28). Pairwise comparisons showed no significant difference between treated and treatment-naïve hypertensive groups, but both differed significantly from normotensive controls. Serum magnesium and calcium imbalance was significantly associated with hypertension status, with magnesium showing the stronger association. Prospective studies with larger samples and adjustment for age, sex, BMI, diet, medication use and other potential confounders are warranted to clarify temporal relationships and clinical significance and to assess potential clinical implications.