CoQ10 and Blood Pressure: What We Know
Managing blood pressure is a cornerstone of good heart health. While lifestyle and medication are the mainstays of treatment, many people are curious about the role of supplements. One that often comes up is Coenzyme Q10, or CoQ10. But what does the science actually say?
This article provides a straightforward summary of the evidence on CoQ10 for blood pressure, its safety, and how it fits with a heart-healthy lifestyle.
What is Coenzyme Q10?
Coenzyme Q10 is a vitamin-like compound that your body produces naturally. It's found in every cell and plays a vital role in creating energy within the mitochondria, the powerhouses of your cells. As an antioxidant, it also helps protect cells from oxidative damage. The British Heart Foundation notes that the highest concentrations of CoQ10 are found in your most active organs, including the heart and brain.
While your body can synthesise CoQ10 from the amino acid tyrosine, production declines with age. Some medications, particularly statins used to lower cholesterol, can also reduce CoQ10 levels by blocking the same biochemical pathway needed to make both cholesterol and CoQ10.
You can get small amounts from food. The richest sources are organ meats like liver and kidney, fatty fish such as salmon, mackerel, and sardines, and smaller amounts in whole grains, nuts, and vegetable oils. However, dietary intake alone typically provides only a few milligrams per day, far less than the amounts studied in clinical trials.
The evidence on CoQ10 and blood pressure
The research on CoQ10's effect on blood pressure is mixed, and the context matters considerably.
A 2022 meta-analysis published in Advances in Nutrition examined 26 randomised controlled trials involving 1,831 people with cardiometabolic conditions such as diabetes, dyslipidaemia, and metabolic syndrome. The analysis found that CoQ10 supplementation led to a statistically significant reduction in systolic blood pressure (the top number) of 4.77 mmHg on average. Diastolic pressure showed a smaller, non-significant decrease.
Importantly, the study identified a U-shaped dose-response relationship. The most effective dose appeared to be between 100–200 mg per day. Doses below or above this range showed diminishing returns. Effects were more pronounced when supplements were taken for longer than 12 weeks and in people with diabetes or high cholesterol rather than isolated hypertension.
The researchers graded the quality of evidence as moderate for systolic blood pressure using the GRADE system, which assesses the reliability of clinical trial data.
However, a 2016 Cochrane Review focused specifically on people with primary hypertension (high blood pressure without another underlying metabolic cause) came to a different conclusion. Pooling data from just two trials with 50 participants, it found no clinically significant effect on either systolic or diastolic blood pressure. The review concluded that CoQ10 does not have a meaningful impact on blood pressure in this group.
This discrepancy suggests CoQ10 may be more helpful when blood pressure issues occur alongside metabolic dysfunction rather than in isolation. The mechanisms aren't fully understood, but may relate to CoQ10's role in improving mitochondrial function and reducing oxidative stress in metabolically compromised tissues.
UK health authorities, including the National Institute for Health and Care Excellence (NICE), do not currently recommend CoQ10 for managing blood pressure or preventing cardiovascular disease. The evidence base is still evolving and not yet strong enough to support routine clinical use.
CoQ10 and statins
Statins are among the most commonly prescribed medications in the UK for lowering cholesterol and reducing cardiovascular risk. Because statins inhibit the enzyme HMG-CoA reductase, they also reduce the body's natural production of CoQ10.
Some people taking statins experience muscle pain and weakness, and it's been theorised that lower CoQ10 levels might contribute to these symptoms. However, studies examining whether CoQ10 supplements reduce statin-related muscle pain have produced mixed and inconclusive results.
The British Heart Foundation states that current evidence does not support taking CoQ10 supplements for statin-attributed muscle pain. NICE guidance also advises against using CoQ10 to increase statin adherence. If you're experiencing muscle pain on statins, speak to your GP about adjusting the dose or trying a different type rather than stopping the medication.
Is CoQ10 safe to take?
CoQ10 is generally considered safe for most people. Side effects are uncommon and usually mild, such as nausea, indigestion, or diarrhoea. It has not been tested in pregnancy, so it's not recommended for pregnant or breastfeeding women.
However, it's important to be aware of potential drug interactions. CoQ10 can interact with warfarin, a blood-thinning medication, potentially reducing its effectiveness. It may also interact with some blood pressure medications. For this reason, it is essential to speak with your GP or a qualified healthcare professional before starting any new supplement, especially if you have an existing health condition or take other medications.
CoQ10 supplements are not regulated in the same way as medicines in the UK. This means the actual amount of CoQ10 in each capsule can vary between brands, and absorption can differ depending on the formulation. Some products use ubiquinol, the reduced form of CoQ10, which may be absorbed more effectively than standard ubiquinone, particularly in older adults.
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Lifestyle comes first
No supplement can replace the powerful benefits of a healthy lifestyle. The British Heart Foundation provides clear, evidence-based advice for managing blood pressure.
Regular physical activity is one of the most effective interventions. Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming. Even small amounts of activity can make a difference.
Diet plays a crucial role. Reducing salt intake is particularly effective for lowering blood pressure. The average UK adult consumes about 8g of salt per day, well above the recommended 6g maximum. Much of this comes from processed foods rather than the salt you add at the table. Focus on whole foods, plenty of fruits and vegetables, and foods rich in potassium, which helps counteract the effects of sodium.
Maintaining a healthy weight is also important. For some people, losing even a modest amount of weight can bring blood pressure down to a normal level without medication.
Alcohol should be consumed in moderation. Current UK guidelines recommend no more than 14 units per week, spread over at least three days, with several alcohol-free days each week.
If you've been prescribed blood pressure medication, take it as directed. Most people need more than one type of medicine to control their blood pressure effectively. Do not stop taking your medication without consulting your GP first, even if you feel well.
Supplements from our heart health collection, such as those containing Omega-3 fatty acids, can complement these efforts. Omega-3s from fish oil have their own evidence base for supporting cardiovascular health. But a solid foundation of healthy habits is key.
Who might benefit from CoQ10?
Based on the current evidence, CoQ10 supplementation at 100–200 mg per day may offer a modest benefit for lowering systolic blood pressure in people with cardiometabolic conditions such as diabetes, metabolic syndrome, or high cholesterol. The effect appears to be small, around 5 mmHg, but could contribute to overall cardiovascular risk reduction when combined with other interventions.
It is unlikely to benefit people with isolated high blood pressure who don't have other metabolic issues.
CoQ10 is not a replacement for prescribed medication. If you have high blood pressure, continue taking your medication as directed by your doctor.
The take-home point
The evidence suggests CoQ10, particularly at doses of 100–200 mg per day taken for at least 12 weeks, may offer a small benefit for lowering blood pressure in people with metabolic conditions. The effect is modest but statistically significant in larger studies. However, it does not appear effective for primary hypertension alone.
CoQ10 is generally safe, but can interact with certain medications, particularly warfarin and some blood pressure drugs. It is not a substitute for lifestyle changes or prescribed treatment.
If you are considering CoQ10, the most important step is to discuss it with your doctor to ensure it is safe and appropriate for you.
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