What is the Role of CoQ10 in Preventing Heart Disease?

What is the Role of CoQ10 in Preventing Heart Disease?

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This review summarizes a larger review published by Ayer et al. Ayer, A., Macdonald, P., & Stocker, R. (2015). CoQ10 Function and Role in Heart Failure and Ischemic Heart Disease. Annual Review of Nutrition, 35(1), 175-213. doi:10.1146/annurev-nutr-071714-034258

CoQ10 Supplement Options: http://amzn.to/2qQIHDx

Heart Failure.

Briefly, heart failure has different meanings depending on who you are talking to and what specifically you are talking about. For example, heart failure to a cardiologist means many different things as there are different types including acute, congestive, systolic, or diastolic. There are classification systems and ways to measure heart failure, but that is all beyond the scope of this lecture.

For our purposes, heart failure essentially means the heart is inadequately pumping blood. Another lay term for this would be “pump failure”. This can occur because the heart is not squeezing well (most common) or because the muscles are stiff and don’t relax.

Regarding CoQ10, the authors reference about a dozen studies in humans, but point out two key studies that were larger clinical trials. Links to the studies are in the discussion section

The first was published in 1993 by Morisco et al which investigated 640 people with chronic congestive heart failure were randomized to either CoQ10 supplementation (2 mg/kg) or placebo for a year. They found improvement in congestive heart failure symptoms, adverse events and hospitalizations with a non-significant reduction in mortality.

The second was published in 2014 by Mortensen et al looking at 420 patients who were randomized to CoQ10 (100 mg 3x/day) or placebo for one year. At 2 years, 50% reduction in adverse cardiac events (morbidity and mortality, meaning disability and death respectively), improvement in heart failure symptoms

Hypertension

Hypertension is a medical term for high blood pressure. High blood pressure increases your risk of many diseases, most commonly heart attack, stroke and kidney disease. It affects a lot of folks and is often called the ‘silent killer’ because you don’t know you have it until someone measures your blood pressure.

CoQ10 has been studied  as a treatment for hypertension, but mostly in smaller trials.

A systematic review was published in 2007. They combined all the data from 12 seperate studies and concluded that CoQ10 could reduce systolic blood pressure by up to 17 mm Hg (the top number) and diastolic blood pressure by 10 mm Hg (bottom number)

For those of you that don’t know, a systematic review is the gold standard for summarizing a bunch of studies asking the same question and allowing you to draw a conclusion from the combined data. The results of this publication are encouraging for CoQ10 as a potential treatment for high blood pressure.

Ischemic Heart Disease

Ischemic heart disease is a fancy way of saying heart attack and damage to muscle from heart attacks. Ischemic means lack of blood flow, and in this case to the heart. This lack of blood flow starves the heart muscle of oxygen and eventually will cause it to die. This is what we call a heart attack.

Studies reviewing the effect of CoQ10 on ischemic heart disease are lacking, both for initial heart attacks and preventing a second one.

The largest study was published in 2003 where the authors randomized 144 patients who had just had a heart attack to either coenzyme Q10 or B vitamins. They reported a reduction in chest pain, cardiac arrhythmias, and adverse cardiac events and heart attacks at 4 weeks and 1 year. Big limitation here, the control arm did not get a placebo, they got B vitamins! This makes it hard to draw conclusions

Citations

Ayer, A., Macdonald, P., & Stocker, R. (2015). CoQ 10 Function and Role in Heart Failure and Ischemic Heart Disease. Annu. Rev. Nutr. Annual Review of Nutrition, 175-213.

Morisco, C., Trimarco, B., & Condorelli, M. (1993). Effect of coenzyme Q10 therapy in patients with congestive heart failure: A long-term multicenter randomized study. Clin Investig The Clinical Investigator.

Mortensen, S., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K., Pella, D., . . . Littarru, G. (2014). The Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure. JACC: Heart Failure, 641-649.

Rosenfeldt, F., Haas, S., Krum, H., Hadj, A., Ng, K., Leong, J., & Watts, G. (2007). Coenzyme Q10 in the treatment of hypertension: A meta-analysis of the clinical trials. J Hum Hypertens Journal of Human Hypertension.

Singh, R., Neki, N., Kartikey, K., Pella, D., Kumar, A., Niaz, M., & Thakur, A. (2003). Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Vascular Biochemistry, 75-82

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