Coenzyme Q10 and Heart Disease
Coenzyme Q10 (CoQ10) is a popular supplement to support heart health. And while there are some intriguing suggestions of benefits in the literature, overall, a lot of the findings for CoQ10 are quite mixed.
What is CoQ10?
CoQ10 is an antioxidant molecule that plays a key role in what’s called the mitochondrial electron transport chain. Mitochondria are the powerhouse of your cells, producing cellular energy as adenosine triphosphate (ATP). Inside these tiny powerhouses is a folded membrane with embedded biochemical factories that complete the final processing of food into stored energy. To produce ATP, these little factories pass energy rich electrons along carrier molecules. By stripping away negatively charged electrons, positively charged hydrogens are left behind which produces a voltage difference across the membrane. This voltage difference is used in the final assembly of the ATP molecule.
In this biochemical process, CoQ10 is one of the carriers utilized for transferring electrons along the chain. Not surprisingly, since CoQ10 can accept electrons, it acts as a potent antioxidant throughout the body. Additional CoQ10 may also support energy production in general, a strategy that might have applications in a number of different health conditions.
CoQ10 and Heart Disease
Effects on Lipids
Effects of CoQ10 on lipids, including cholesterol and triglycerides are mixed. One recent meta-analysis concluded that in metabolic diseases, CoQ10 lowers triglycerides and potentially lowers total cholesterol, while raising LDL and HDL slightly, although findings on cholesterol did not reach statistical significance (Sharifi 2018). The researchers concluded that higher doses and a longer period of treatment may help better estimate treatment effects.
In another study, effects on lipoprotein(a) were assessed. Lipoprotein(a) molecules are cholesterol-like particles that have been associated with heart disease. A meta-analysis on CoQ10 found a modest reduction in lipoprotein(a) in patients on CoQ10 supplementation. However, they didn’t show significant effects on cholesterol or triglycerides (Sahebkar 2016). A separate systematic review on CoQ10 in patients with coronary artery disease found that CoQ10 could reduce total cholesterol and raise HDL, although they found no effects on triglycerides and lipoprotein(a) (Jorat 2018). Obviously, more research is needed to clarify effects since many of the recent systematic analyses have shown benefits but reached opposite conclusions.
Effects on Blood Pressure
Research on the mechanism of CoQ10 for helping blood pressure shows a number of interesting effects. Studies in humans appear to indicate that CoQ10 may have a direct effect on blood vessels. CoQ10 appears to decreases smooth muscle constriction, dropping blood pressure (Digiesi 1994). Other avenues of research suggest the antioxidant component of CoQ10 may be a factor for blood pressure control (Belardinelli 2008). Antioxidants protect the delicate production of nitric oxide, a key signaling molecule involved with relaxing the walls of blood vessels.
Like cholesterol, some studies have found significant benefits of CoQ10 on blood pressure, where other trials have not (Ayers 2018). More research is necessary to confirm the effects of CoQ10 on blood pressure. Studies can also help clarify who will most benefit.
Effects on Heart Failure
Research on heart failure suggests potential benefits with CoQ10. In patients, the severity of the condition correlates with CoQ10 levels in the body (Folkers 1985). Probably the best study on heart failure showed a 43% reduction in major heart events with CoQ10. They also found improvement in heart function (Mortensen 2014). In the study, patients treated with CoQ10 reduced mortality by almost half.
Based on the evidence in total, a recent review concluded that CoQ10 may be a promising approach for heart failure. In addition, the benefits appear to be prevalent without any major safety issues (Di Lorenzo 2020).
CoQ10 may have benefits for heart disease and heart failure. However, there are limitations in our current understanding of the supplement and its best use. Unfortunately, CoQ10 is not well absorbed. Some of the variable findings throughout the research could be due to differences in CoQ10 supplements, dosing, length of treatment and study subjects. Recently, better absorbed forms of CoQ10 are starting to become more widely available. These newer forms may increase the benefits. Future research can help better flesh out how best to utilize CoQ10 to protect heart health.