Coenzyme Q10 (CoQ10) is one of the most effective natural remedies for high blood pressure, and is prescribed as a medical treatment in some countries, such as Japan, to improve blood pressure control.
Coenzyme Q10 is needed for energy production
Coenyme Q10 is a vitamin-like substance present in most body cells, where it is needed for the production of energy within the mitochondria, cell structures which act rather like batteries. Cells which work the hardest have the most mitochondria and the highest need for coenzyme Q10 – especially muscle cells such as those in your heart.
After the age of 20, your blood levels of coenzyme Q10 begin to fall for two reasons: you absorb dietary coenzyme Q10 less efficiently, and the amount made in your cells start to decline. By the age of 40, the amount of CoQ10 present in heart muscle and artery lining cells is up to 32% lower than when you were in your 20s, for example, and by the age of 80 has halved again.
Derived from: Kahn et al. Lipids 1989; 24(7):579-584
Without co-enzyme Q10, cells cannot produce energy as well as normal and function less efficiently. Muscle cells in artery linings are less able to dilate and contract to normalise blood pressure and, when levels become significantly low, heart muscle contraction is impaired.
Research suggests that falling CoQ10 levels play a significant role in age-related medical conditions such as hypertension, coronary heart disease, heart attack and heart failure.
Biopsies from patients with various forms of heart disease have shown that up to 75 per cent are deficient in CoQ10, and lower levels of CoQ10 are associated with more severe heart disease.
Coenzyme Q10 for high blood pressure
Coenzyme Q10 improves the elasticity and reactivity of artery walls. Adding 225 mg CoQ10 to existing anti-hypertensive treatment was found to produce significant, gradual improvements in blood pressure in a study involving 109 people with hypertension. As a result, just over half (51%) were able to stop between one and three of their antihypertensive drugs (under the supervision of a cardiologist) within 4.4 month after starting Coenzyme Q10. Those whose heart contraction was assessed also showed a significant improvement in left ventricular wall thickness and function so heart pumping became more efficient. Only three per cent of patients required the addition of one antihypertensive drug despite CoQ10 treatment.
The results from 3 trials, involving 96 people, found that in people with high blood pressure, taking coenzyme Q10 supplements reduced their readings, on average, by 11/7 mmHg compared with inactive placebo.
A larger analysis, using data from 12 clinical trials, involving over 360 people, found that Coenzyme Q10 reduced blood pressure by up to 16.6/8.2 mmHg compared with placebo. This included a cross-over trial, in which the same group of people took Coenzyme Q10 or placebo for a period of time, then crossed over to take the other treatment (so they acted as their own controls). Their blood pressures were, on average, 11/8 mmHg lower when they were taking the co-enzyme Q10 supplements than when they were taking placebo, and there were no significant side effects.
Coenzyme Q10 and statins
Statin drugs lower cholesterol levels by blocking an enzyme (HMG-CoA reductase) needed to synthesise cholesterol. This same enzyme is needed within cells to produce co-enzyme Q10. Levels of coenzyme Q10 fall quickly when you start taking a statin and are halved within two to four weeks. This may contribute to the muscle-related side effects some people experience when taking a statin (as may the fact that statins reduce vitamin D synthesis).
Taking co-enzyme Q10 supplements (eg ubiquinol 100mg or ubiquinone 200mg) helps to maintain blood levels of this important muscle nutrient without affecting the cholesterol-lowering action of the statin.
Ubiquinol versus ubiquinone
Until recently, only the oxidised form of CoQ10 (ubiquinone) was available. This must be converted into a reduced, active form (ubiquinol, or Co-enzyme QH) for use within cells. This conversion becomes increasingly less efficient with age.
Advances in manufacturing mean the reduced ‘body-ready’ ubiquinol (coenzyme QH) is now also available in supplement form, although it tends to be more expensive. A dose of 100mg ubiquinol is equivalent to around 280mg ubiquinone.
A form known as mitoquinone has also been developed which carries a positive electrical charge. This is said to enhance its transport across the mitochondrial membrane into the negatively charged interior of mitochondria. This ‘super bio available’ form is more expensive but is needed in smaller amounts, at a typical dose of 5mg, and may be suitable for those with mitochondrial dysfunction who have not obtained sufficient benefit from ubiquinol.
Doses of co-enzyme Q10
As well as making some co-enzyme Q10 in your cells, you obtain small amounts from cell-based foods such as offal, meat, fish, whole grains, nuts and green leaves. Average dietary intakes are low, however, at an estimated 5mg for meat eaters and 1mg daily for vegetarians.
If you have high blood pressure, or are on a statin drug, an initial dose is usually 100mg ubiquinol (or 200mg ubiquinone). Doses can be increased if benefits are not obtained within two months.
As CoQ10 is fat soluble, it’s best taken with food to improve absorption. It usually takes at least three weeks and occasionally up to three months to notice the full benefits
As coenzyme Q10 is oil soluble, supplements are best taken as gel caps in which the CoQ10 is dissolved in oil, and consumed with food to improve absorption.
Co-enzyme Q10 appears to be a safe supplement with few side effects (apart from the lowering of blood pressure).
If your blood pressure is borderline or raised, self-monitoring is key to maintaining good control.
Click here for advice on choosing a blood pressure monitor to use at home.
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