From the Guidelines
Coenzyme Q10 (CoQ10) supplementation is recommended for patients with cardiometabolic disorders to reduce blood pressure and improve overall health outcomes, as evidenced by a recent systematic review and meta-analysis published in 2022 1. The role of CoQ10 in reducing morbidity and mortality is significant, particularly in patients with high blood pressure, as it has been shown to decrease systolic blood pressure (SBP) in people with metabolic diseases 1. Key points to consider when recommending CoQ10 supplementation include:
- The optimal intake of CoQ10 supplementation is still unclear, but a dose-response relation has been established to determine the effective dose of CoQ10 supplementation on attenuating blood pressure 1
- CoQ10 plays an essential role in energy metabolism and antioxidant protection, and its deficiency has been implicated in patients with cardiometabolic disorders 1
- CoQ10 supplementation has been shown to be beneficial in reducing blood pressure, particularly in patients with metabolic diseases, with a significant decrease in SBP observed in recent studies 1
- The certainty of the evidence supporting CoQ10 supplementation has been evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, providing a comprehensive update on the potential clinical translatability of CoQ10 supplementation 1 In clinical practice, CoQ10 supplementation can be considered as a complementary approach to reduce blood pressure and improve overall health outcomes in patients with cardiometabolic disorders, particularly when used in conjunction with other evidence-based treatments 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Role of Coenzyme Q10 (CoQ10)
- CoQ10 is an endogenously synthesised and diet-supplied lipid-soluble cofactor that functions in the mitochondrial inner membrane to transfer electrons from complexes I and II to complex III 2
- CoQ10 acts as a membrane antioxidant due to its redox activity 2
- CoQ10 deficiency may be associated with a multitude of diseases, including heart failure, and the severity of heart failure correlates with the severity of CoQ10 deficiency 3, 4
- CoQ10 may help to reduce the toxic effects of reactive oxygen species in people with heart failure due to its antioxidant activity 3, 4
- CoQ10 may have a role in stabilising myocardial calcium-dependent ion channels and preventing the consumption of metabolites essential for adenosine-5'-triphosphate (ATP) synthesis 3, 4
CoQ10 and Heart Failure
- Several randomised controlled trials have compared CoQ10 to other therapeutic modalities, and meta-analyses have confirmed improvements in functional parameters such as ejection fraction, stroke volume, and cardiac output 2, 5
- CoQ10 probably reduces the risk of all-cause mortality and hospitalisation related to heart failure 3
- There is low-quality evidence of inconclusive results as to whether CoQ10 has an effect on the risk of myocardial infarction or stroke 3
- CoQ10 may improve the left ventricular ejection fraction, but the results are inconclusive for exercise capacity 3, 4
Clinical Evidence
- The Q-SYMBIO trial found that CoQ10 significantly reduced the primary long-term endpoint, a major adverse cardiovascular event, in patients with heart failure 2
- A meta-analysis found that CoQ10 resulted in an improvement in ejection fraction of 3.7% and the mean increase in cardiac output was 0.28 L/minute 5
- The included studies provide moderate-quality evidence that CoQ10 probably reduces all-cause mortality and hospitalisation for heart failure, but the quality of the evidence is downgraded due to high risk of bias and imprecision 3