To the Editor.
—Dr Baker and colleagues1 do not mention the importance of magnesium insufficiency and/or depletion in the pharmacologic treatment of heart failure. Patients with congestive heart failure have lower levels of magnesium compared with levels in those without disease,2 and diuretics and digoxin induce magnesium depletion as well as potassium depletion.3 In fact, repletion of magnesium is a significant contributor to the reversal of hypokalemia and digitalis toxicity.4,5 The incidence of heart failure after suspected myocardial infarction was reduced 25% with early intravenous magnesium administration in the Leicester Magnesium Trials.6
Anderson R. Pharmacologic Treatment of Congestive Heart Failure. JAMA. 1995;273(19):1491-1492. doi:10.1001/jama.1995.03520430027027