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 …
When? 2003 – 2010.
Study participants were enrolled in the study from January 2003 to February 2010 …
Senior citizens living in the small Swedish municipality of Kinda about 3 hours’ drive south of Stockholm …
Why? To document the effect of selenium and Coenzyme Q10 supplementation on senior citizens.
To evaluate the effect of daily combined supplementation with 200 micrograms of an organic high-selenium yeast preparation and 200 milligrams of Coenzyme Q10 in a primary health care cohort has a significant effect on the severity of chronic heart failure, all-cause mortality, and cardiovascular mortality and to evaluate the effect of the combined intervention on heart function as measured by cardiac natriuretic peptides and echocardiography …
How? Reduced cardiovascular mortality, improved heart function.
How did the KiSel-10 study turn out? … the combination intervention with high-selenium yeast and Coenzyme Q10 was associated with the following statistically significant outcomes that were documented by Dr. Alehagen and the team of researchers:
- reduced the risk of dying from heart disease by 54% (p=0.02)
- improved heart function as compared to placebo as seen on echocardiograms (p=0.03)
- reduced the levels of the bio-marker NT-proBNP, a reliable indicator of heart disease (p=0.014)
- reduced the number of hospitalizations compared to placebo for study participants matched for age, gender and heart function at the start of the study
- slowed the decline in the quality of life compared to placebo, especially with respect to physical performance, vitality, somatic dimension, conative dimension, and global function (p=0.001)
- reduced the levels of the oxidative stress bio-markers copeptin (p=0.031) and adrenomedullin (p=0.026)
- showed significant differences in the levels of the inflammation bio-markers C-reactive protein (p=0.004) and sP-selectin (p=0.01) between the intervention group and the placebo group 
- showed significant differences in the expression of more than 100 different microRNAs with as a result of the intervention with selenium and Coenzyme Q10 combined (p=0.05)
- showed significantly lower bio-markers for cardiac fibrosis in seven of eight bio-markers tested 
- showed increased levels of insulin-like growth factor-1 (p=0.0001), age-adjusted IGF-1 SD score (p=0.0001) and post-prandial IGFBP-1 p=0.009), compared with placebo 
- showed reduced cardiovascular mortality even after ten years by 48% (p=0.0003) and also reduced all-cause mortality after ten years (p=0.041)
- showed reduced cardiovascular mortality compared to placebo after 12 years (p=0.001)
Explanation of the synergistic effect of Coenzyme Q10 and selenium
Professor Alehagen posits that there is a special interrelationship between Coenzyme Q10 and selenium in the body .
Insufficient selenium concentrations can keep the cells from getting adequate concentrations of Coenzyme Q10. At the same time, the cells need sufficient Coenzyme Q10 levels to achieve optimal selenium function.
Bottom line … what have we learned from the KiSel-10 study?
Daily supplementation with 200 micrograms of an organic high-selenium yeast preparation and a pharmaceutical-grade Coenzyme Q10 has the following health benefits in senior citizens:
- reduces cardiovascular mortality, especially if the senior citizens have low serum selenium levels at baseline 
- improves heart function 
- slows the normal decline in heart function seen during aging 
- decreases the levels of inflammation, oxidative stress, and atherosclerosis [3,4]
- increases the quality of life and reduces the number of hospitalizations 
- has a lasting effect for years after the intervention has ended [5,11]
1. Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., Post, C., & Aaseth, J. (2016). Relatively high mortality risk in elderly Swedish subjects with low selenium status. European Journal of Clinical Nutrition, 70(1), 91-96.
2. Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and Coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.
3. Alehagen, U., Lindahl, T. L., Aaseth, J., Svensson, E., & Johansson, P. (2015). Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial. Plos One, 10(9), e0137680.
4. Alehagen, U., Aaseth, J., & Johansson, P. (2015). Less increase of copeptin and MR-proADM due to intervention with selenium and coenzyme Q10 combined: Results from a 4-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Biofactors (Oxford, England), 41(6), 443-452.
5. Alehagen, U., Aaseth, J., & Johansson, P. (2015). Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. Plos One, 10(12), e0141641.
6. Alehagen, U., & Aaseth, J. (2015). Selenium and Coenzyme Q10 interrelationship in cardiovascular diseases–A clinician’s point of view. Journal of Trace Elements in Medicine and Biology, 31157-162.
7. Alehagen, U., Alexander, J., & Aaseth, J. (2016). Supplementation with Selenium and Coenzyme Q10 Reduces Cardiovascular Mortality in Elderly with Low Selenium Status. A Secondary Analysis of a Randomised Clinical Trial. Plos One, 11(7), e0157541.
8. Alehagen, U., Johansson, P., Aaseth, J., Alexander, J., & Wågsäter, D. (2017). Significant changes in circulating microRNA by dietary supplementation of selenium and Coenzyme Q10 in healthy elderly males. A subgroup analysis of a prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Plos One, 12(4), e0174880.
9. Alehagen, U., Johansson, P., Aaseth, J., Alexander, J., & Brismar, K. (2017). Increase in insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 1 after supplementation with selenium and Coenzyme Q10. A prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Plos One, 12(6), e0178614.
10. Alehagen, U., Aaseth, J., Alexander, J., Svensson, E., Johansson, P., & Larsson, A. (2017). Less fibrosis in elderly subjects supplemented with selenium and coenzyme Q10-A mechanism behind reduced cardiovascular mortality? Biofactors (Oxford, England), doi:10.1002/biof.1404.
11. Alehagen, U., Aaseth, J., Alexander, J., & Johansson, P. (2018). Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. Plos One, 13(4), e0193120.
12. Johansson, P., Dahlström, Ö., Dahlström, U., & Alehagen, U. (2013). Effect of selenium and Q10 on the cardiac biomarker NT-proBNP. Scandinavian Cardiovascular Journal: SCJ, 47(5), 281-288.
13. Johansson, P., Dahlström, Ö., Dahlström, U., & Alehagen, U. (2015). Improved Health-Related Quality of Life, and More Days out of Hospital with Supplementation with Selenium and Coenzyme Q10 Combined. Results from a Double Blind, Placebo-Controlled Prospective Study. The Journal of Nutrition, Health & Aging, 19(9), 870-877.
The information presented in this review article is not intended as medical advice and should not be used as such.