Coenzyme Q(10) as Adjunctive Therapy for Cardiovascular Disease and Hypertension: A Systematic Review

Background Mitochondrial ATP production requires a small electron carrier, coenzyme Q(10) (CoQ(10)), which has been used as adjunctive therapy in patients with cardiovascular disease (CVD) and hypertension (HTN) because of its bioenergetics and antioxidant properties. Randomized controlled trials (RCTs) beyond the last 2 decades evaluating CoQ(10) added to conventional therapy resulted in mixed results and were underpowered to address major clinical endpoints. Objectives The objective of this systematic review was to examine the impact of CoQ(10) supplementation on older adults with CVD or HTN in the last 2 decades (2000-2020). Methods PubMed/Medline, Cochrane Database, CINAHL, and Google Scholar databases were searched systematically, and references from selected studies were manually reviewed, to identify RCTs or crossover studies evaluating the efficacy of CoQ(10) supplementation. Data extracted from selected studies included trial design and duration, treatment, dose, participant characteristics, study variables, and important findings. Results A total of 14 studies (1067 participants) met the inclusion criteria. The effect of CoQ(10) supplementation was examined among predominantly older adult males with heart failure (HF) (n = 6), HTN (n = 4), and ischemic heart disease (n = 3), and preoperatively in patients scheduled for cardiac surgery (n = 1). CoQ(10) supplementation in patients with HF improved functional capacity, increased serum CoQ(10) concentrations, and led to fewer major adverse cardiovascular events. CoQ(10) had positive quantifiable effects on inflammatory markers in patients with ischemic heart disease. Myocardial hemodynamics improved in patients who received CoQ(10) supplementation before cardiac surgery. Effects on HTN were inconclusive. Conclusions In predominantly older adult males with CVD or HTN, CoQ(10) supplementation added to conventional therapy is safe and offers benefits clinically and at the cellular level. However, results of the trials need to be viewed with caution, and further studies are indicated before widespread usage of CoQ(10) is recommended in all older adults.

Automated summary

Coenzyme Q(10) (CoQ(10)) supplementation added to conventional therapy is safe and beneficial in predominantly older adult males with cardiovascular disease (CVD) or hypertension (HTN) at both clinical and cellular levels. However, caution should be exercised when interpreting the results of the trials, and further research is needed before recommending widespread usage of CoQ(10) in all older adults.