Adjunctive treatment of The Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term patients with 3 times 100 milligrams of Coenzyme Q10 daily for two years gave the following The outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant. ... Read more about this term results compared with placebo treatment [Mortensen 2014]:
- reduced number of deaths from heart disease
- reduced number of deaths from all causes
- reduced number of heart failure related hospitalizations
- improved The New York Heart Association Functional Classification distinguishes four categories of heart failure according to how much the patients are limited in their physical activity. Category I: No limitation of physical activity. No undue fatigue, palpitation, or shortness of breath. Category II: Slight limitation of physical activity. Comfortable at rest. Fatigue, palpitation, or shortness of breath at ordinary physical activity.... Read more about this term class
Absorption and Bioavailability of the CoQ10 Supplement
CoQ10 supplements are very different from one another. The CoQ10 supplement that gave the beneficial heart health outcomes listed above is a specially formulated CoQ10 preparation, specially formulated with respect to the carrier oils in which the Coenzyme Q10 raw material is dispersed and with respect to the heating and cooling process used in the manufacture of the supplement. It has documented absorption and bioavailability.
Many, perhaps most, of the CoQ10 products for sale in Europe and the United States cannot be expected to give the same heart health benefits as were demonstrated in the Q-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... Read more about this term of the effect of Coenzyme Q10 on morbidity and mortality in chronic heart failure.
Coenzyme Q10 Difficult to Absorb
The CoQ10 raw material comes as a crystalline powder. The human body cannot absorb the CoQ10 crystals. The crystals must be dissociated in the manufacturing process to single CoQ10 molecules. The CoQ10 molecules themselves are large, fat-soluble molecules, too large to be absorbed via the capillary system directly into the blood. They must pass from the intestinal absorption cells to the lymph and then transit the lymph to reach the blood circulation.
Coenzyme Q10 for ATP Energy Generation and Antioxidant Protection
Once absorbed, Coenzyme Q10 provides antioxidant protection for lipoproteins in the blood plasma. When it reaches the tissue cells, Coenzyme Q10 plays an essential role in ATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production.... Read more about this term energy generation and as an Antioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... Read more about this term neutralizing harmful Free radicals are unstable and highly reactive molecules that are produced in the body during normal oxygen metabolism. Free radicals derived from oxygen are known as reactive oxygen species. Free radicals play both helpful and harmful roles in the body. Free radicals steal electrons from other substances in order to become stable. In so doing, the free radicals oxidize those... Read more about this term.
Coenzyme Q10 for Management of Heart Failure
The results of a 2017 meta-analysis have shown that CoQ10 supplementation of heart failure patients was associated with significantly improved exercise capacity (indicating improved quality of life) and with significantly decreased mortality [Lei 2017].
Aggregated data in a 2013 meta-analysis of 13 randomized controlled trials has shown that CoQ10 treatment was associated with a small but significant improvement of Ejection fraction, sometimes called left ventricular ejection fraction, measures the percentage of blood that the heart pumps out of the left ventricle with each heart contraction. According to the Mayo Clinic guidelines, an ejection fraction above 55% is regarded as normal. An ejection fraction under 50% is regarded as reduced. An ejection fraction below 40% is indicative of heart failure... Read more about this term and with a borderline improvement in NYHA class (p=0.06) [Fotino 2013].
Data from a 2013 Cochrane Database review has showed that CoQ10 supplementation lowered the rate of hospitalization and improved the NYHA class in heart failure patients [Madmani 2013].
Coenzyme Q10 for Management of Hypertension
Pooled data from a 2007 meta-analysis of 12 clinical trials has shown that Coenzyme Q10 supplementation lowered systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without significant side effects in hypertensive patients [Rosenfeldt 2007].
Coenzyme Q10 and Statin-Induced Muscle Pain and Weakness
A meta-analysis of data from 12 clinical trials has shown that statin medications of varying intensities and durations significantly decreased circulating CoQ10 concentrations [Qu 2018]. This occurs because the statin medication inhibits the bio-synthesis of Coenzyme Q10 in the same way that it inhibits the bio-synthesis of Cholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... Read more about this term [Okuyama 2015].
A meta-analysis of 12 randomized controlled trials has shown that, compared with placebo, CoQ10 supplementation significantly relieved statin-associated muscle symptoms: muscle pain, muscle weakness, muscle cramp, and muscle tiredness [Qu 2018].
Conclusion: Coenzyme Q10 for Heart Disease Prevention and Treatment
In the words of Dr. Mortensen, lead researcher on the Q-Symbio Study of adjuvant treatment of chronic heart failure patients with Coenzyme Q10: Coenzyme Q10 is safe, well-tolerated, effective, affordable.
And in the words of Dr. Lopez-Lluch, lead researcher on the Bioavailability of Coenzyme Q10 Supplements Study: Seven tested formulations showed large and significant differences in bioavailability.
Take-home message: Buying a cheap, undocumented CoQ10 supplement could be a waste of hard-earned money. A good documented CoQ10 supplement can improve the health-related quality of life.
Fotino AD, Thompson-Paul AM, Bazzano LA: Effect of coenzyme Q10 supplementation on heart failure: a meta-analysis.; Am J Clin Nutr 2013 97 268-75
Lei L & Liu Y. Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials. BMC Cardiovascular Disorders, 2017. 17(1): 196.
López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez AB & Navas, P. Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 2019 57, 133–140.
Madmani ME, Yusuf Solaiman A, Tamr Agha K, Madmani Y: Coenzyme Q10 for heart failure.; Cochrane Database Syst Rev 2014 CD008684
Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P & Littarru GP. The Effect of Coenzyme Q on Morbidity and Mortality in Chronic Heart FailureResults From Q-SYMBIO: A Randomized A double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken.... Read more about this term Trial; JACC Heart Fail 2014 641-9
Okuyama H, Langsjoen PH, Hamazaki T: Statins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10.... Read more about this term stimulate Atherosclerosis is the thickening of the artery walls brought about by the build-up of plaque (plaque is made up of cholesterol and other fatty substances and waste products and calcium and fibrin) and the subsequent slowing of the flow of blood through the clogged arteries. More research is needed into the role of Coenzyme Q10 in the prevention and adjunct... Read more about this term and heart failure: pharmacological mechanisms; Expert Rev. Clin. Pharmacol. 2015 189-99
Qu H, Guo M, Chai H, Wang WT, et al.: Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis ofRandomized Controlled; J Am Heart Assoc 2018 19 e009835
Rosenfeldt FL, Haas SJ, Krum H, Hadj A, et al.: Coenzyme Q10 in the treatment of Hypertension is abnormally high blood pressure, usually defined as adult systolic blood pressure above 140 mm Hg or adult diastolic blood pressure above 90 mm Hg. Systolic blood pressure is blood pressure measured during the contracting (pumping) of the left ventricle of the heart. Diastolic blood pressure is blood pressure measured during the relaxation of the left ventricle. A meta-analysis... Read more about this term: ameta-analysis of the clinical trials.; J Hum Hypertens. 2007 21 297-306.
The information contained in this review article is not intended as medical advice and should not be used as such.
25 June 2020Please click here for more information about the heart health benefits of Coenzyme Q10 supplementation.