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Effect of Coenzyme Q10 Supplementation on Vascular Endothelial Function: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Shahrzad Daei, Azam Ildarabadi, Sima Goodarzi, Mohsen Mohamadi-Sartang
High Blood Pressure & Cardiovascular Prevention 2024 31(2):113-126

Bibliography

PubMed
PMID 38630421
DOI
10.1007/s40292-024-00630-8
Funding
No funds, grants or other support were reported for preparation of the manuscript.
Competing interests
The authors reported no relevant financial or non-financial competing interests.

Study snapshot

DesignSystematic review and meta-analysis of randomized controlled trials
ModelSystematic review and random-effects meta-analysis of randomized controlled trials evaluating CoQ10 supplementation and endothelial-function markers.
Sample12 randomized trials; 489 participants.
InterventionCoQ10 supplementation versus placebo/control; included trials used approximately 100–300 mg/day over roughly 4–24 weeks.
DurationApproximately 4–24 weeks across included trials; effects were explored by duration, including ≥8 weeks.
EndpointsFlow-mediated dilation (FMD); VCAM-1; ICAM-1; Dose-response/meta-regression; Subgroup analyses; Publication bias; Sensitivity analysis

What the study showed, in plain terms

This 2024 meta-analysis combined 12 randomized trials (489 participants) to examine whether CoQ10 changes vascular endothelial function. The clearest signal was for brachial flow-mediated dilation (FMD), a surrogate measure of endothelium-dependent vasodilation.

CoQ10 increased FMD by a weighted mean 1.45 percentage points (95% CI 0.55–2.36; p<0.02). In contrast, circulating adhesion markers VCAM-1 and ICAM-1 did not show statistically significant overall changes.

Meta-regression suggested a dose-related FMD response (slope 0.01; 95% CI 0.004–0.03; p=0.006), and the authors reported clearer FMD effects after at least eight weeks. These findings support an endothelial-function signal but do not directly establish fewer cardiovascular events.

Key findings

FMD: WMD +1.45 percentage points, 95% CI 0.55–2.36, p<0.02; significant improvement in endothelium-dependent vasodilation.

VCAM-1: SMD -0.34, 95% CI approximately -0.74 to 0.06, p≈0.10—no statistically significant overall effect.

ICAM-1: SMD -0.18, 95% CI -0.82 to 0.46, p≈0.57—no statistically significant overall effect.

Dose-response: FMD change was associated with CoQ10 dose in meta-regression (slope 0.01, 95% CI 0.004–0.03; p=0.006).

Duration: the authors concluded that an FMD effect was evident after at least 8 weeks of supplementation.

Interpretation: evidence concerns surrogate vascular physiology rather than myocardial infarction, stroke or mortality outcomes.

What this study can and cannot tell us

Only 12 trials and 489 participants were available, and individual studies were generally small.

Populations, baseline cardiovascular/metabolic status, CoQ10 dose and treatment duration varied, contributing to clinical heterogeneity.

FMD, ICAM-1 and VCAM-1 are surrogate markers; improvement in FMD does not by itself prove reduction in cardiovascular events.

Dose and duration subgroup/meta-regression findings are observational comparisons across trials and should not be interpreted as definitive head-to-head dosing evidence.

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