Low Coenzyme Q10 Status and Increased Heart Disease Risk

Japanese cardiologists have reported a significantThe 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 connection between low Coenzyme Q10 status and the risk of death from heart disease and other causes [Shimizu 2020].

• The researchers collected and examined blood samples from 242 men and women admitted to Juntendo University Hospital’s coronary care unit in Tokyo.
• They followed the heart disease patients for a three-year period.
• 58 of the 242 patients (24%) died during the follow-up period from heart disease, cancer, infection, and other causes.
• The patients who died had an average blood CoQ10 concentration of 0.48 micrograms per milliliter. The patients who survived had a higher average blood CoQ10 concentration of 0.58 micrograms per milliliter.
• Overall, the researchers found that patients with a “higher” blood CoQ10 concentration of 0.46 or greater micrograms per milliliter had a 52% lesser likelihood of dying from all causes than did the patients with blood CoQ10 concentrations below 0.46 micrograms per milliliter.
• Nota bene: The patients with the low CoQ10 blood levels were the patients with the higher dosages of statin medications.

Why Low CoQ10 Levels are Associated with Heart Disease Mortality

This research shows that heart disease patients with lower blood CoQ10 levels are at greater risk of dying sooner than heart disease patients with higher blood CoQ10 levels [Shimizu 2020].

• Statin medications are known to inhibit the body’s endogenous production of Coenzyme Q10; logically, every heart patient taking a statin medication will need adjunctive Coenzyme Q10 treatment. Okuyama et al [2015] have explained the mechanisms by which statin medication may increase the risk of developing atherosclerosisAtherosclerosis 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 failureThe 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.
• Lower blood CoQ10 levels are also associated with greater age [Shimizu 2017]. Malnutrition among senior citizens may be contributing to low CoQ10 status; this is another argument for supplementation.
• Adequate levels of Coenzyme Q10 are associated with reduced levels of blood bio-markers for inflammationInflammation is an immune system response to an injury to cells or tissues. It is the body’s attempt to defend against invaders such as bacteria andviruses and to mend the damage done by invaders. Typically, inflammation manifests itself in the form of fever and swelling, in the swarming of white blood cells and the release of cytokines to fight against... Read more about this term, in particular interleukin 6, C-reactive protein, and tumor necrosis factor alpha [Fan 2017].

Evidence from CoQ10 Supplementation and Heart Disease Studies

• Professor Urban Alehagen’s KiSel-10 Study has shown that daily supplementation of senior citizens with Coenzyme Q10 and selenium-enriched yeast for four years cuts the risk of heart disease in half [Alehagen 2013].
• Professor Svend Aage Mortensen’s Q-Symbio Study has shown that adjunctive treatment of chronic heart failure patients with Coenzyme Q10 for two years significantly reduces the risk of death from heart disease and of death from all causes [Mortensen 2014; Mortensen 2019].

Bottom Line: CoQ10 Status and Cardiovascular Disease risk

Adequate levels of Coenzyme Q10 are essential to the cells’ production of ATPATP (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; moreover, Coenzyme Q10 is an important lipid-soluble antioxidantAntioxidants 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 that scavenges harmful free radicalsFree 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 [Shimizu 2017].

• In the KiSel-10 Study, the senior citizens received 2 times 100 milligrams of Coenzyme Q10 daily [Alehagen 2013].
• In the Q-Symbio Study, the heart failure patients received 3 times 100 milligrams of Coenzyme Q10 daily [Mortensen 2014].

Separate doses of CoQ10, taken with meals containing some fat, will give a better absorption than single doses will [Singh 2005].

The formulation of the CoQ10 supplement – the combination of carrier oils and the heating/cooling process is much more important to absorption and bio-availability than the form of the CoQ10 supplement is. Whether the CoQ10 supplement is composed of ubiquinoneUbiquinone, the oxidized form of Coenzyme Q10, expressed as Q10 or CoQ10, is absolutely essential for the mitochondrial ATP energy production process. Ubiquinone is the form of Coenzyme Q10 that the body synthesizes, and ubiquinone is the form of Coenzyme Q10 that has been extensively tested for safety, absorption, and efficacy in clinical trials.... Read more about this term or ubiquinol is much less important than the care the manufacturer puts into the formulation of the supplement [Lopez-Lluch 2019].

Remember: All Coenzyme Q10 formulations are not equally well absorbed. It is a bit of a gamble to buy a cheap CoQ10 supplement. Without absorption, there cannot be good health health effects.

Sources

Alehagen U, Johansson P, Björnstedt M, Rosén A, Dahlström U. Cardiovascular mortality and N-terminal-proBNP reduced after combined seleniumSelenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... Read more about this term and coenzyme Q10 supplementation: a 5-year prospective randomized double-blindA 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 placebo-controlled trial among elderly Swedish citizens. Int J Cardiol. 2013 Sep 1;167(5):1860-6. doi: 10.1016/j.ijcard.2012.04.156. Epub 2012 May 23.

Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trialsRandomized controlled trials are studies in which patients or healthy volunteers are assigned at random (purely by chance) to receive one or more clinical interventions. One or more of the interventions is the active treatment being tested. Another of the interventions is the control against which the active treatment is being tested. The control is, typically, the standard practice or... Read more about this term. Pharmacol Res. 2017 May;119:128-136. doi: 10.1016/j.phrs.2017.01.032. Epub 2017 Feb 5.

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 Jan;57:133-140. doi: 10.1016/j.nut.2018.05.020. Epub 2018 Jun 27

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO StudyQ-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 Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failureThe 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: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9. doi: 10.1016/j.jchf.2014.06.008. Epub 2014 Oct 1.

Mortensen AL, Rosenfeldt F, Filipiak KJ. Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial. Cardiol J. 2019;26(2):147-156. doi: 10.5603/CJ.a2019.0022. Epub 2019 Mar 5.

Okuyama H, Langsjoen PH, Hamazaki T, Ogushi Y, Hama R, Kobayashi T, Uchino H. StatinsStatins 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 and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol. 2015 Mar;8(2):189-99. doi: 10.1586/17512433.2015.1011125. Epub 2015 Feb 6.

Shimizu M, Miyazaki T, Takagi A, Sugita Y, Ouchi S, Aikawa T, Shiozawa T, Hiki M, Takahashi S, Hiki M, Shimada K, Daida H. Low coenzyme Q10 levels in patients with acute cardiovascular disease are associated with long-term mortality. Heart Vessels. 2020 Sep 16. doi: 10.1007/s00380-020-01698-7. Epub.

Shimizu M, Miyazaki T, Takagi A, Sugita Y, Yatsu S, Murata A, Kato T, Suda S, Ouchi S, Aikawa T, Hiki M, Takahashi S, Hiki M, Hayashi H, Kasai T, Shimada K, Miyauchi K, Daida H. Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit. Heart Vessels. 2017 Jun;32(6):668-673. doi: 10.1007/s00380-016-0923-x. Epub 2016 Dec 9.

Singh RB, Niaz MA, Kumar A, Sindberg CD, Moesgaard S, Littarru GP. Effect on absorption and oxidative stress of different oral Coenzyme Q10 dosages and intake strategy in healthy men. Biofactors. 2005;25(1-4):219-24. doi: 10.1002/biof.5520250127.

The information presented in this review article is not intended as medical advice and should not be used as such.

30 November 2020