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Cardiovascular Care and Endothelial Health

Protecting endothelial function is central to a comprehensive cardiovascular care protocol—here’s how ubiquinol helps.

 

With the number of deaths from cardiovascular diseases on the rise, heart health remains a growing concern for practitioners. Over the past three decades, cardiovascular-related deaths have been steadily increasing, and in 2021, heart disease and stroke killed more Americans than all forms of cancer combined. Coronary artery disease accounts for one-third to one-half of all cardiovascular diseases, with impaired endothelial function known to be a primary causal factor. The good news: a targeted protocol that includes ubiquinol supplementation can protect endothelial health, lessen the likelihood of heart attack, stroke and other cardiovascular events and safeguard your patients’ hearts for years to come. Here’s what the science shows.1, 2, 3, 4

Enhancing endothelial health: the role of CoQ10

Endothelial function plays a central role in various aspects of cardiovascular health, maintaining vascular homeostasis, regulating blood pressure, preventing platelet aggregation and controlling inflammation. Dozens of studies implicate endothelial dysfunction in the development and progression of atherosclerosis, coronary artery disease, heart attack and stroke, and significantly higher rates of cardiovascular events.5, 6, 7, 8, 9, 10

Disruptions in endothelial function appear to result from reduced levels of nitric oxide production and bioavailability, leading to impaired vasodilation, increased blood pressure, inflammation in arterial walls, platelet aggregation and vessel permeability. Common risk factors include insulin resistance, obesity, elevated LDL and reduced HDL cholesterol, nicotine use and a family history of early cardiovascular disease. Mental stress, thought to be mediated through endothelin, is also associated with prolonged endothelial dysfunction, especially in women.11, 12, 13, 14, 15, 16

CoQ10 has long been recognized as a valuable component of overall cardiovascular protection, with a large body of research highlighting its therapeutic potential in hypertension, ischemic heart disease, heart failure, cardiomyopathies, dyslipidemia, obesity and a range of related risk factors and disorders. In studies, CoQ10 interventions are linked with significant improvements in endothelial function, better treatment outcomes in patients with heart failure and reduced mortality from cardiovascular causes. CoQ10 supplementation is critical for older patients, since deficiencies are common in chronic and age-related diseases, and in those taking statins.17, 18, 19, 20, 21, 22

Ubiquinol: the superior form of CoQ10

The reduced form of CoQ10, ubiquinol is an even more powerful ally in promoting endothelial function, decreasing inflammation and oxidative stress, and protecting other aspects of cardiovascular health.

Conventional CoQ10 supplements usually occur as ubiquinone, the oxidized form, which must be converted by the body to ubiquinol, the active form. But this process is slow and limited, and aging further hampers the body’s efficiency in absorbing and converting CoQ10. Ubiquinol supplements are identical to naturally occurring ubiquinol, requiring no conversion in the body to perform antioxidant functions. Compared to conventional CoQ10, ubiquinol is readily absorbed and significantly more bioavailable. In clinical trials, ubiquinol forms of CoQ10 were two to four times better absorbed than ubiquinone forms, resulting in markedly higher plasma CoQ10, with research demonstrating a five- to eight-fold increase in serum ubiquinol levels.23, 24, 25, 26, 27, 28, 29

Ubiquinol supports heart health through a variety of mechanisms. Mitochondria serve as the primary energy source for the heart muscle, fueling its high-energy needs and aiding physiological processes vital for cardiovascular wellness. Any disruptions in mitochondrial function directly contribute to the development of cardiovascular disease. CoQ10 plays a central role in the mitochondrial respiratory chain, required for 95 percent of cellular ATP. It’s also a crucial antioxidant in the inner mitochondrial membrane, a major site of free radical production. By supporting mitochondrial health, ubiquinol protects endothelial cells against senescence, potentially delaying vascular aging.30, 31, 32, 33

In its reduced form, ubiquinol is endowed with powerful antioxidant activity, shielding mitochondria and lipid membranes from oxidative stress, a key risk factor for cardiovascular disease. Ubiquinol has been shown to neutralize reactive oxygen species generated as a by-product of mitochondrial energy formation. Within the vascular system, ubiquinol is particularly potent, preventing LDL oxidation, protecting endothelial cells from oxidative stress and promoting vessel health. Beyond these mechanisms, ubiquinol also appears to affect cellular biochemistry by modulating gene expression and reducing inflammation, strongly implicated in endothelial dysfunction and the development and progression of arteriosclerosis and coronary artery disease.34, 35, 36, 37, 38, 39

Other research shows ubiquinol supplementation improved blood markers associated with heart health, including reduced serum GGT activity, lower serum NT-proBNP and CRP levels, all linked with a decreased risk for cardiovascular events and heart failure. Other studies point to ubiquinol’s benefits on endothelial function  specifically. Clinical trials demonstrate the value of ubiquinol treatment for supporting vessel health in three ways: enhancing vasodilation, promoting nitric oxide production and protecting low-density lipoprotein (LDL) cholesterol from oxidation.40, 41, 42, 43, 44, 45

In a randomized, double-blind, single-center trial, ubiquinol supplementation significantly improved endothelial function as measured by flow-mediated dilation (FMD) compared with placebo. Participants received either ubiquinol at doses of 100mg or 200mg per day or placebo for eight weeks. The study found ubiquinol ameliorated dyslipidemia-related endothelial dysfunction, with improved serum nitrate and nitrite levels at both 100mg or 200mg per day and a higher LDL oxidation lag time at doses of 200mg per day. After eight weeks, ubiquinol treatment led to mean 1.3 percent FMD increase in both treated groups. According to the latest census report, each 1 percent point rise in FMD involves a notable 8 to 13 precent reduction in risk of cardiovascular events.46, 47

In studies of smaller populations, ubiquinol was shown to restore depleted CoQ10 and improve ejection fraction. A case series of 29 cardiac patients found participants who switched from CoQ10 to ubiquinol for a mean duration of 18 months demonstrated significantly higher levels of  serum CoQ10, and average ejection fraction increased from 40.9 percent to 47.8 percent. In a trial of 50 patients, ubiquinol replenished plasma ubiquinol depleted during aortic valve replacement surgery, compared to placebo. And a crossover pilot study of 14 patients found 400mg of ubiquinol per day for three months improved peripheral endothelial function in participants with heart failure with reduced ejection fraction.48, 49, 50

Superior absorption is especially crucial for older patients. During aging, ubiquinol concentrations and antioxidant mechanisms naturally decline, endangering healthy cells and mitochondria and fueling common age-related conditions. Aging further diminishes the body’s ability to absorb and convert ubiquinone forms of CoQ10 into ubiquinol. Highly absorbable ubiquinone is also vital for replenishing CoQ10 depleted by statins. Clinical research validates the importance of maintaining ubiquinol during aging, and in older populations, optimal serum ubiquinol levels are associated not only with improved cardiovascular health, but also enhanced muscle strength, physical functioning and overall wellness.51, 52, 53, 54, 55

References:

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