Heart disease is a serious and growing problem. In the US, it’s responsible for more premature deaths than all cancers combined. The good news is that the vast majority heart disease cases are preventable. And CoQ10 is a dietary supplement that may go some way toward preventing this disease and improving heart health. In this post we take a look at the impact of CoQ10 on heart health as well as its role in the treatment of heart disease and heart failure.
- CoQ10 is essential for energy generation in muscles such as the heart
- Low levels are associated with increased risk of heart disease and vice versa
- Multiple randomized controlled trials have demonstrated CoQ10 supplementation improves the symptoms of heart failure and reduces the risk of death
- Consensus is almost universal that CoQ10 is an effective adjunct therapy for heart health
What is CoQ10?
Coenzyme Q10 (CoQ10) is an enzyme cofactor that’s vital for many biological processes.
CoQ10 is necessary for aerobic cellular respiration and as such is vital for energy generation. Unsurprisingly, CoQ10 concentration is highest in organs that require the most energy, such as the liver, kidneys and heart.
But CoQ10 levels decline with age. What’s more, CoQ10 levels have been shown to be lower in individuals with heart disease.
Cardiovascular disease (heart disease) is the name given to a range of conditions where the heart isn’t working properly.
Heart disease is the number one cause of premature death worldwide1. In the USA alone, 610,000 people a year die from related conditions1 – that’s 1 in 4 premature deaths or more than all deaths caused by cancer combined.
Common symptoms of heart disease include:
- Chest pain
- Difficulty breathing
- Irregular heartbeat (palpitations)
- Blue skin tone (cyanosis)
- Weakness caused by low blood supply
The vast majority of heart disease is acquired heart disease as opposed to congenital. And while there is a genetic component to acquired heart disease, the good news is that 90% is preventable1.
Heart disease can be prevented by eating a healthy diet, getting regular exercise and cutting out cigarettes and excessive alcohol consumption. Current health advice recommends reducing consumption of saturated fat to reduce the risk of heart disease1 but there is a growing body of evidence to suggest other factors – particularly sugar consumption – are far more important1,2,3,4.
Proper dietary supplementation is another way to reduce the risk of heart disease. CoQ10 in particular shows promise for preventing heart disease and heart failure.
Heart disease and CoQ10
Population studies have shown CoQ10 levels are inversely correlated with cardiovascular disease.
The Inuits of Greenland, for example, have high levels of serum CoQ10 but low incidence of heart disease1. And at the other end of the scale, Indians and South Asians are more susceptible to heart disease and typically have low levels of CoQ101.
This suggests that low CoQ10 levels is a risk factor for heart disease. And research in Western populations backs this up.
In this study, for example, a large group of patients with cardiovascular disease were given varying doses of supplemental CoQ10 in addition to their existing medicines. At the start of the study, most patients were taking between one and five medications. But after 8 years of CoQ10 many were able to reduce this number.
What’s more, the researchers also noted significant improvements in the symptoms associated with heart disease:
“Over an eight year period (1985-1993), we treated 424 patients with various forms of cardiovascular disease by adding coenzyme Q10 (CoQ10) to their medical regimens. Doses of CoQ10 ranged from 75 to 600 mg/day by mouth (average 242 mg). […] A statistically significant improvement in myocardial function was documented using the following echocardiographic parameters: left ventricular wall thickness, mitral valve inflow slope and fractional shortening. […] During this study, overall medication requirements dropped considerably: 43% stopped between one and three drugs.”
– Usefulness of coenzyme Q10 in clinical cardiology: a long-term study. PMID: 7752828
And these findings have been replicated in similar studies.
Here, 443 elderly but healthy Swedish subjects were randomly assigned CoQ10 and selenium or placebo. After 5 years, the researchers observed a “significant reduction of cardiovascular mortality was found in the active treatment group vs. the placebo group”1.
The researchers also conducted a 10 year follow up study. Again, they noted:
“Significantly reduced cardiovascular mortality could be seen in those on selenium and coenzyme Q10 intervention.”
– 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. PMCID: PMC4666408
Of course, it’s possible the improved cardiovascular health seen in the active treatment group could be attributed solely to the selenium. But given the other studies discussed, it seems likely that CoQ10 played an important role in preventing heart disease.
CoQ10 and heart failure
In many cases, heart disease can eventually lead to heart failure – a state where the heart is unable to meet the body’s demands for blood.
It’s estimated that around 2% of adults suffer from heart failure. And this number increases to around 6-10% for those aged 65 and over1.
The risk of dying within the first year of heart failure diagnosis is around 35%. But this risk decreases by 10% a year thereafter1. This is where CoQ10 comes in.
Studies have shown CoQ10 supplementation to increase cardiac output and improve heart function. In other words, it improves the symptoms of heart failure.
These findings aren’t just from one or two obscure trials, either. Meta-analyses (i.e. studies of studies) confirm that the effects of CoQ10 supplementation are very much real:
“The relevant effect parameters investigated were stroke volume (SV), cardiac output (CO), ejection fraction (EF), cardiac index (CI), end diastolic volume index (EDVI), systolic time intervals (PEP/LVET) and total work capacity (Wmax). Seven meta-analyses were performed, one for each of the parameters, and the calculated effect sizes were all positive.“
Perhaps unsurprisingly, these improved symptoms translate to better health and reduced chance of death.
Another meta-analysis looked at 14 studies to determine whether CoQ10 reduced the risk of death in patients with heart failure:
“A total of 14 [randomized controlled trials] with 2149 patients met the inclusion criteria and were included in the analysis. Coenzyme Q10 decreased the mortality compared with placebo […] Patients with heart failure who used coenzyme Q10 had lower mortality and a higher exercise capacity improvement than the placebo-treated patients with heart failure.”
The methods and large sample size of these combined trials leaves little room for doubt that CoQ10 can improve the symptoms of heart disease and reduce the risk.
“Significant improvement has been observed in clinical and hemodynamic parameters and in exercise tolerance in patients given adjunctive CoQ10 in doses from 60 to 200 mg daily in the various trials conducted in patients of heart failure, hypertension, ischemic heart disease and other cardiac illnesses”
While CoQ10 is found naturally in some foods, supplementation is the easiest way to ensure you are getting adequate intake of this vital coenzyme. As described in the trial above, dosages of 60mg to 200mg per day have been used in trials for various cardiovascular disorders.
As for diet, the most abundant sources of dietary CoQ10 are meat and fish. Heart and liver meat has particularly high concentrations.
CoQ10 can also be found in fruit, nuts and oils such as soybean and olive oil1.
Summary: CoQ10 for heart health
“CoQ10 is a safe and effective adjunctive treatment for a broad range of cardiovascular diseases, producing gratifying clinical responses while easing the medical and financial burden of multidrug therapy.”
Heart disease and heart failure are serious health disorders that can result in death. They’re also becoming increasingly common.
But most cases of cardiovascular disease are preventable. Here, we’ve seen plenty of evidence that CoQ10 supplementation can improve the symptoms of cardiovascular disorders – and even that it can reduce the risk of death.
But this does not mean CoQ10 is a cure.
While the evidence is pretty conclusive that CoQ10 has beneficial effects on heart health, it is not a substitute for proper diet, exercise or professionally prescribed medications. It is, however, a potentially effective adjunct to these interventions.