Coenzyme Q10 (CoQ10), or ubiquinol, is a widely studied compound recognized for its vital role in mitochondrial function, antioxidant defense, and overall support of cardiovascular and neurological health. CoQ10 is a fat-soluble nutrient located in the inner mitochondrial membrane, playing a major role in ATP production for cellular energy. Its antioxidant properties protect cellular organelles against oxidative damage.
CoQ10 is synthesized endogenously and can be obtained through diet and supplements. With certain conditions, such as hypertension (HTN), the body cannot synthesize enough CoQ10. As CoQ10 levels decline and oxidative stress increases with age, CoQ10 supplementation has shown therapeutic benefits in aging-related disorders.
There are many proposed mechanisms of CoQ10’s role in HTN. Evidence shows that oxidative stress reduces levels of the key antioxidant superoxide dismutase (SOD), which decreases nitric oxide (NO) availability. Reduced NO results in vasoconstriction and HTN. CoQ10 enhances SOD activity, NO availability, and improves vascular endothelial flow-mediated dilation, ultimately reducing blood pressure (BP).
Additionally, CoQ10 has anti-inflammatory properties and, along with mitigating oxidative stress, may improve arterial elasticity and reduce arterial stiffness. Optimizing mitochondrial ATP production optimizes cardiac output and systolic BP.
Previous meta-analyses of randomized controlled trials (RCTs) show mixed results regarding CoQ10’s effects on systolic and diastolic BP. This prompted a research group to conduct a more recent meta-analysis to determine CoQ10’s effectiveness in reducing BP among different populations, and to identify moderating factors such as supplement dosage, duration of use, and other characteristics that may influence outcomes.
The Study
A 2025 systematic review and meta-analysis published in the International Journal of Cardiology aimed to evaluate the effectiveness of CoQ10 on BP and heart rate (HR) in adults. Findings show that CoQ10 may be effective for reducing systolic blood pressure.
After an exclusion process, 45 RCTs published between 1985 and 2024 were included in the study. The study populations included patients with type 2 diabetes, cardiovascular disease (CVD), chronic kidney disease, HTN, dyslipidemia, metabolic syndrome, and healthy participants. Most trials were double-blind RCTs (n=41). Trials ranged from 12 hours to 96 weeks, and CoQ10 doses ranged from 20 mg to 1200 mg daily.
The researchers found that CoQ10 significantly reduced systolic BP by a weighted mean difference (WMD) of -3.48 mmHg. Subgroup analysis suggests that doses lower than 200 mg/day and interventions longer than 8 weeks resulted in greater systolic BP reductions (WMD= -6.05 mmHg and WMD= -4.67 mmHg, respectively). Findings were more pronounced in participants with preexisting health conditions compared to healthy cohorts. A nonsignificant reduction in diastolic BP and no impact on HR was seen with CoQ10 administration.
Because of variability in previous meta-analysis findings, assessing risk of bias is important in interpreting results. This study acknowledged that while some trials maintained a low risk of bias, others showed concerns, and caution is needed when interpreting the results.
Conclusions
This meta-analysis, along with a few others, supports the benefit of CoQ10 on systolic BP reduction. Even modest reductions in systolic blood pressure are associated with a lower incidence of cardiovascular events. CoQ10 is generally considered safe, and study authors suggest that it may serve as a complementary therapy for individuals with HTN or at risk of CVD. However, more large-scale RCTs are needed to establish optimal dosing and efficacy across diverse populations.
