Coenzyme Q10 supplementation and coronary artery disease

Elevated total cholesterol levels and/or elevated low-density lipoprotein (LDL) cholesterol levels are associated with increased risk of coronary artery disease, which is the most common form of heart disease. Now, a meta-analysis shows that CoQ10 supplementation significantly improves total cholesterol and HDL-cholesterol in coronary artery disease patients.

Coenzyme Q10 adjuvant treatment of heart failure patients significantly improves the symptoms and survival of chronic heart failure patients [Mortensen; Morisco; Munkholm].

How does it look with Coenzyme Q10 supplementation and coronary artery disease?

Coronary artery disease is caused by hardening and narrowing of the coronary arteries that bring blood to the heart muscle? Coronary artery disease is also known as ischemic heart disease, which is heart disease characterized by reduced flow of blood containing oxygen to the heart muscle.

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Coenzyme Q10 adjuvant therapy for chronic heart failure

Dr. Svend Aage Mortensen (right), pictured here with Dr. Karl Folkers, was the lead researcher on the Q-Symbio study of the effects of Coenzyme Q10 adjuvant therapy for chronic heart failure patients. Now, Dr. Anne Louise Mortensen has focused in on the European patients in the international Q-Symbio study.

There are positive outcomes from an analysis of the European sub-group of chronic heart failure patients (n = 231 out of a total of 420 patients) in the international multi-center Q-Symbio study.  Two years of adjuvant treatment with 3 times 100 milligrams of ubiquinone Coenzyme Q10 daily in addition to conventional heart failure treatment reveals [Mortensen 2019]:

  • significantly fewer patients suffering major adverse cardiovascular events (= death due to heart attack or heart failure or hospitalization due to acute heart failure or pulmonary embolism) compared to placebo
  • significantly fewer heart disease deaths and all-cause deaths compared to placebo
  • significantly more improvements of the patients’ NYHA classifications compared to placebo
  • significantly improved ejection fraction compared to placebo

What was the Q-Symbio study of CoQ10 and heart failure?

The Q-Symbio study was an international multi-center randomized, double-blind, placebo-controlled study that demonstrated that daily treatment with 3 times 100 milligrams of a pharmaceutical-grade ubiquinone Coenzyme Q10 preparation for two years in addition to conventional treatment significantly improved the symptoms and survival of chronic heart failure patients [Mortensen 2014].

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Coenzyme Q10 and selenium supplementation for senior citizens

One of Sweden’s leading cardiologists, Professor Urban Alehagen, Department of Cardiology, Linkoping University Hospital, led the KiSel-10 research team. Dr. Alehagen conceived the idea of combining the essential trace element selenium and the vitamin-like substance Coenzyme Q10 to improve the heart health of senior citizens.  In so doing, he and his team of  researchers reduced the cardiovascular mortality of live-at-home senior citizens by over 50 per cent and improved heart function.

Let’s take a close look at the KiSel-10 clinical trial of the effect of combined selenium and Coenzyme Q10 supplementation on the heart health of senior citizens.

Who? Senior citizens.

Senior citizens … aged 70 – 88 years … average age 78 years … still living at home … generally in good health … in a clinical trial conducted by Dr. Urban Alehagen and a team of researchers from Linköping University, Linköping, Sweden …

What? Combined selenium and Coenzyme Q10 supplementation.

The KiSel-10 study enrolling 443 study participants in a four-year randomized, double-blind, placebo-controlled trial … the study name KiSel-10 is derived from the name of the municipality Kinda, the trace element selenium, and the Coenzyme Q10 … the Coenzyme Q10 used in the KiSel-10 study is the same pharmaceutical-grade Coenzyme Q10 preparation that was used in the Q-Symbio study of adjuvant treatment of chronic heart failure patients with 300 milligrams of Coenzyme Q10 (3 times 100 milligrams daily) … the Coenzyme Q10 used in both the KiSel-10 study and the Q-Symbio study was the ubiquinone form, the most tested and documented form and the most stable form …

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Big new Coenzyme Q10 in heart failure study proposed in the UK

The thickened heart muscle makes it more difficult for the heart to pump out adequate quantities of blood. Source: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2).

Researchers in the United Kingdom are developed the methodology for a new randomized controlled trial of the efficacy of Coenzyme Q10 adjunctive treatment of heart failure patients.

Two earlier randomized controlled studies have produced results suggesting that daily supplementation with Coenzyme Q10 substantially reduces the morbidity and mortality in patients who are at risk for or have been diagnosed with heart failure.

Q-Symbio Study: Daily supplementation with 300 milligrams of Coenzyme Q10 for two years significantly improved the symptoms, quality of life, and survival of chronic heart failure patients [Mortensen 2014].

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Coenzyme Q10 is a life-long essential supplement

Dr. William V. Judy, founder and president of SIBR Research Institute, has done studies of Coenzyme Q10 supplementation of patients with chronic heart failure and chronic fatigue syndrome. Generally, after 10 -12 weeks of supplementation, the patients’ symptoms and quality of life improve significantly. However, if the supplementation is stopped, the patients suffer a relapse to their previous condition. Coenzyme Q10 supplementation is a life-long adjuvant therapy.

Coenzyme Q10 is a life-time essential supplement for most people as they get on in years.  People who especially need a Coenzyme Q10 supplement – heart failure patients and chronic fatigue syndrome patients, for example – will suffer a relapse if they stop taking their daily CoQ10 supplements.

CoQ10 and the constant need for ATP energy

Dr. William Judy, founder and president of the SIBR Research Institute, tells me that the life-long need for Coenzyme Q10 supplementation is related to the cells’ constant need for ATP energy.

Excesses of ATP energy cannot be stored.  The cells must produce ATP energy when they need the energy.  CoQ10 is a vital co-factor in the production of ATP energy in the cells.

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Coenzyme Q10 supplements: cheaper is not a good investment

In a double-blind, cross-over study, Professor Guillermo Lopez-Lluch and a team of researchers at the Pablo de Olavide University in Sevilla, Spain, have demonstrated that the composition and the formulation of the supplement is very important to the absorption and bio-availability of the Coenzyme Q10.

On this website, we review the results of clinical trials of the effects of oral Coenzyme Q10 supplementation.  We high-light human studies that show the following significant health benefits of taking a well-formulated CoQ10 supplement:

  • Improved symptoms and survival of heart failure patients
  • Reduced risk of death from heart disease and better maintained heart function among senior citizens
  • Improved quality of life for chronic fatigue syndrome patients
  • Faster recovery with fewer complications following heart surgery
  • Lowered systolic and diastolic blood pressure
  • Reduced frequency and intensity of migraine headaches

Why the need for CoQ10 supplementation?

Bio-synthesis of CoQ10 falling with increasing age.

Yes, our bodies do synthesize Coenzyme Q10 in almost all cells; however, the bio-synthesis of Coenzyme Q10 is a complicated multi-step process, and the extent of Coenzyme Q10 bio-synthesis decreases with increasing age once we pass our 20s.

Insufficient uptake of CoQ10 from the diet.

Moreover, it is difficult to get enough Coenzyme Q10 from our food alone to make up the difference in the declining endogenous production of CoQ10.  Remember, too, that it becomes more difficult to extract nutrients from our food as we get older.

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Coenzyme Q10: the European Q-Symbio study analysis

Biochemist Anne-Louise Mortensen shows that serum Coenzyme Q10 levels above 3.0 micrograms per milliliter can be achieved through daily supplementation with 300 milligrams of a patented ubiquinone Coenzyme Q10 supplement. The outcomes of the long-term supplementation of chronic heart failure patients were reduced risk of death from heart disease, reduced risk of death from all causes, reduced incidence of hospitalization, and reduced incidence of other major adverse cardiovascular events.

The Q-Symbio randomized, double-blind, placebo-controlled study of the effect of Coenzyme Q10 adjunctive treatment on the symptoms, adverse cardiovascular events, and survival of chronic heart failure patients is the single best Coenzyme Q10 clinical study that we have.

The Q-Symbio study was a two-year multi-center study enrolling 420 patients with moderate to severe heart failure.  The patients were randomly assigned to an active treatment group receiving 100 milligrams of Coenzyme Q10 three times a day or to a group taking matching placebos three times a day [Mortensen 2014].  The Coenzyme Q10 or placebo treatment was given in addition to the conventional heart failure medication.  The patients were recruited for the study in several European, Asian, and Australian countries.

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Highlights of the 9th International Coenzyme Q10 Association Conference

The 9th Conference of the International Coenzyme Q10 Association was held June 21 – 24 in the Faculty House at Columbia University in New York. Researchers from many different countries and continents attended.

What did the leading Coenzyme Q10 researchers have to say in New York?

  • Coenzyme Q10 has three primary fields of activity in the body: as a co-factor in the energy production process in the cells, as a fat-soluble antioxidant protecting cells against oxidative damage, and as a regulator of endothelial function.  In addition, Coenzyme Q10 has anti-inflammatory properties and plays a role in proper cell signaling activity.
  • The most recently published data from the KiSel-10 study done in Sweden shows that the beneficial heart health effects of supplementation of elderly live-at-home individuals with a combination of Coenzyme Q10 and high-selenium yeast have persisted through year 12.
  • A bio-availability study done at a university in Spain shows that the formulation of the Coenzyme Q10 supplement is even more important than the form of the supplement.  The absorption of a well-formulated ubiquinone Coenzyme Q10 supplement is better than the absorption of a ubiquinol supplement.
  • A sub-group analysis of the data from the Q-Symbio study of the effect of adjunctive Coenzyme Q10 treatment on European chronic heart failure patients shows even better results for Europeans than for all patients in the multi-center study.
  • Studies show that there may be interactions between Coenzyme Q10 and other nutritional supplements, meaning that we should be careful not to take these supplements at the same time we take our Coenzyme Q10.
  • The consensus at the conference was that the therapeutic level of Coenzyme Q10 in the plasma or serum is somewhere between 2.5 and 3.5 micrograms per milliliter.  Above 4.0 micrograms per milliliter, the beneficial effect of Coenzyme Q10 supplementation is thought to flatten out.
  • Statin medications only deprive the body of Coenzyme Q10 by inhibiting the bio-synthesis of Coenzyme Q10 just as they inhibit the bio-synthesis of cholesterol.  Now there is evidence that long-term use of statins has undesirable effects on cognitive function and on memory in particular.  The statins easily cross the blood-brain barrier and adversely affect the protective myelin sheaths in which cholesterol is a key component.

More about these topics below.

The 9th conference of the International Coenzyme Q10 Conference at Columbia University in New York

Every three years, the International Coenzyme Q10 Association (ICQA) holds a conference at which researchers from around the world present their research findings related to Coenzyme Q10.  This year, the conference was held at Columbia University in New York the 21st-24th of June. Many of the presentations and papers concerned the biochemistry of Coenzyme Q10’s effects.

In this article, I want to focus in on the presentations of results from human clinical studies.  In the clinical area, the emphasis was demonstrating the importance of Coenzyme Q10 supplementation to heart health, healthy ageing, and better quality of life.

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Coenzyme Q10 and statin medications

A set of pharmacological mechanisms suggests that the use of statin medications may be stimulating the development of atherosclerosis and chronic heart failure.  Japanese and American researchers have documented the mechanisms by which statin medications may be causing coronary artery calcification.  They propose that the guidelines regulating the use of statin medications be critically re-evaluated [Okuyama 2015].

Statin medications reduce total and bad cholesterol levels but may not reduce the extent of atherosclerosis or the risk of chronic heart failure.                         Attribution: By BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons.
If the researchers are correct, then, yes, statin medications do reduce total cholesterol and bad cholesterol levels.  However, statin medications may not reduce the incidence of coronary heart disease.  Furthermore, statin medications may be at least partially responsible for the increased incidence of chronic heart failure that has been observed in the period since statin medications were introduced in 1987.

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Coenzyme Q10 as heart failure medicine

Chronic heart failure is characterized by an energy starved heart.  The Q-Symbio study’s lead researcher, Dr. Svend Aage Mortensen, treated chronic heart failure patients with 300 milligrams of Coenzyme Q10 daily as an adjunctive treatment to the conventional heart failure medications. His thinking was that the conventional treatments block rather enhance cellular processes and do not address the heart muscle cells’ need for the cofactor Coenzyme Q10 in the ATP energy production process. He used Coenzyme Q10 supplements to address the dysfunction of cellular bio-energetics that is associated with heart failure.

The Q-Symbio randomized, double-blind, controlled study of the effect of Coenzyme Q10 supplementation on morbidity and mortality in heart failure shows that adjuvant supplementation of heart failure patients with 300 milligrams of Coenzyme Q10 daily reduces the all-cause risk of death by half [Mortensen 2014].  The 300-milligram dosage was administered in 100-milligram increments three times a day, always with meals.  Dr. Svend Aage Mortensen, the lead researcher on the Q-Symbio study, recommended that daily administration of Coenzyme Q10 should become a component of the standard treatment of heart failure [Mortensen 2015].

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