From the Guidelines
Coenzyme Q10 (CoQ10) supplements may be useful for specific conditions, such as reducing blood pressure in patients with cardiometabolic disorders, and are generally well-tolerated with minimal side effects. The most recent and highest quality study, a systematic review and meta-analysis of randomized controlled trials published in 2022 1, found that CoQ10 supplementation significantly decreased systolic blood pressure (SBP) in patients with cardiometabolic disorders, with a mean decrease of -4.77 mmHg. The study also found that the effects of CoQ10 supplementation on SBP were more pronounced in patients with diabetes and dyslipidemia, and that a dose of 100-200 mg/d was associated with the greatest reduction in SBP. Some key points to consider when using CoQ10 supplements include:
- CoQ10 works as an antioxidant and plays a crucial role in cellular energy production, particularly in high-energy organs like the heart.
- Our bodies naturally produce CoQ10, but levels decline with age and certain medications (especially statins) can reduce production.
- CoQ10 supplements may interact with blood thinners and should be discussed with a healthcare provider before starting, especially for those on multiple medications.
- The quality of evidence for the use of CoQ10 supplements is generally moderate to low, and further research is needed to fully understand their effects and optimal dosing. However, based on the current evidence, taking 100-200 mg/d of CoQ10 supplementation may be beneficial for reducing SBP in patients with cardiometabolic disorders 1.
From the Research
CoQ10 as a Supplement
- CoQ10 is one of the most commonly used dietary supplements in the USA, with potential benefits in managing coronary heart disease due to its antioxidant and anti-inflammatory effects 2.
- The supplement has been studied for its possible use in mitigating statin-associated muscle symptoms (SAMS), although results have been mixed, and it appears to be safe 2.
- CoQ10 supplementation has also been researched in patients with heart failure, showing improvements in functional capacity and reductions in cardiovascular events and mortality, such as in the Q-SYMBIO trial 2.
Efficacy and Safety
- Scientific evidence supports the efficacy and safety of CoQ10 supplementation, particularly in reducing oxidative stress and mortality from cardiovascular causes 3.
- CoQ10 has been found to improve clinical outcomes in patients undergoing coronary artery bypass graft surgery, prevent the accumulation of oxLDL in arteries, decrease vascular stiffness and hypertension, and improve endothelial dysfunction 3.
- However, effects on specific cardiovascular risk factors such as blood pressure, dyslipidemia, and glycemic control are less impressive, and current evidence does not support routine use of CoQ10 in patients with coronary heart disease 2.
Clinical Evidence
- Clinical trials have investigated the effects of CoQ10 supplementation in heart failure, showing potential prognostic advantages with no adverse hemodynamic profile or safety issues 4.
- A systematic review of randomized controlled trials found that CoQ10 supplementation improved functional capacity, increased serum CoQ10 concentrations, and led to fewer major adverse cardiovascular events in patients with heart failure 5.
- CoQ10 supplementation has also been found to have positive effects on inflammatory markers in patients with ischemic heart disease and improve myocardial hemodynamics in patients undergoing cardiac surgery 5.