Tag: statins

Q10 increases survival in heart failure

Claus Hancke

May 24, 2022

New review article highlights ubiquinone/Q10 as a first choice for heart failure.

Heart failure is a relatively common disorder, and often occurs as a result of a blood clot in the heart, which has left a scar in the heart muscle. This scar tissue is connective tissue that does not have the normal muscle function of the myocardium, and if a large part of the muscles of the left ventricle in particular is out of order, it is clear that the heart can no longer pump as efficiently.

The most common symptom is dyspnoea, which means that you breathe faster with physical exertion, because the oxygen concentration in the blood can not be maintained when the heart has reduced its ability to pump blood to oxygenate the lungs.

This condition is clinically classified in the so-called “NYHA” groups 1-4, which were once defined by the New York Heart Association, hence the name.

Roughly speaking, in class 1 you have no problems with normal activity, in class 2 you can not run, only walk, in class 3 only sit, and in class 4 you are largely bedridden.

All this is precisely limited by dyspnoea.

The heart failure is diagnosed and graded by ultrasound-Doppler examination and especially the “stroke volume” / EF (Ejection Fraction) of the left ventricle is measured, which is usually around 60% and satisfactory at 50%.

(The volume of the heart is a bit like with the lungs. You can not completely empty it of blood, just as you can not completely empty the lungs of air. Therefore, it is satisfying if the heart can pump out half of its contents at each heart rate.)

The heart muscle can be weakened by many things other than a blood clot, and by any of the transient conditions, such as eg. inflammation of the heart muscle (myocarditis), the pump function can also be restored afterwards.

But after a blood clot, it is difficult because the scar tissue that is formed after the blood clot will never actively pump again.
However, there is hope because the part of the heart muscle that is not damaged may well become stronger.

This is the focus of rehabilitation after a blood clot, but there is also something else that can be done. -You can optimize the energy production in the cells of the myocardium.

Treatment of heart failure
The usual treatment for heart failure was once limited to diuretics and digoxin, but has been under constant development and is today complemented with ACE inhibitors, Procoralan, SGLT-2 inhibitors and even beta-blockers, which were once contraindicated in heart failure. .

This is how the treatments develop continuously, and the idea with the treatment is primarily to relieve the heart and prevent arrhythmias or prevent that you get a blood clot again.

There are also patients with heart failure who benefit from a pacemaker, and if the situation it is completely bad, then a heart pump or a transplant.

Stop for a moment
Before we go off at a tangent maybe we should just try to get a little overview. What exactly do we want to achieve?

We want to achieve that a person with heart failure lives as well as possible for as long as possible.

So should we not try the least invasive treatment so that we avoid many of the heavy side effects following all the above treatments?

All the common treatments are intended to relieve the heart. But there are also options to make the heart stronger so that it pumps better with the remaining muscle tissue. As mentioned, exercise is one of the options, but you can also increase energy production in every single heart muscle cell.

Ubiquinon/Q10
Last week, a review article was published in Journal of Cardiovascular Development and Disease , which reviews 22 scientific articles (20 RCTs) on Q10 used against heart failure.

In the 16 articles, they found significant improvement in pump function (EF) or survival or both. In all cases, there was an inverse correlation between the blood concentration of Q10 and the worsening of the symptoms in patients with heart failure, just as the concentration of Q10 was an indicator of longevity.

In other words, those who had the lowest content of Q10 in the blood had a rapid worsening of the symptoms, just as they lived for a shorter time.
In line with this, it was similarly found that supplementation with Q10 improved the pumping function of the heart and increased the life expectancy of these patients.

The article also focuses on the inappropriate effect of statins, which not only lower cholesterol production but also the production of coenzyme Q10, as these form a common synthetic route from AcetylcoA over mevalonate to farnesyl pyrophosphate. This synthesis requires i.a. the enzyme HMG-CoA reductase and this enzyme is inhibited by statins.

Often, statins are actually prescribed to patients with heart failure, although this should be contraindicated according to the above.
It is noted very laconic that Q10 has at least as good a documentary weight as the treatment that is today considered the gold standard for treating heart failure. Exercise is extremely well documented, whereas digoxin and SGLT-2 inhibitors are poorly documented. Here we must say that Q10 is significantly better documented.

Given the solid evidence and the absence of interactions and side effects with ubiquinone/Q10, it is an obvious first-line treatment for heart failure, and should be implemented throughout the public health system.

 

Claus Hancke
Specialist in general medicine

Ref.

2022 Maj 16, Krzysztof J. Filipiak et al: Heart Failure, -Do We Need New Drugs or Have Them Already? A Case of Coenzyme Q10, J. Cardiovasc. Dev. Dis. 2022, 9, 161

Cholesterol reducing pills: Do they have a downside?

Claus Hancke

August 3, 2005

Medications taken against cholesterol may prolong life in the event of arteriosclerosis and perhaps even heart failure. However, new figures seem to indicate that many patients get serious side effects from taking such medications, which side effects could have been avoided had they also taken Co-enzyme Q10.

Millions of people worldwide use cholesterol reducing medicine in the form of statins. These people most often have clogged coronary arteries and the statins are used to protect them against further atherosclerosis, blood clots, and strokes. They work, but to a lesser degree than many people think.

If they are given to one hundred 40-80 year old people who are at high risk due to atherosclerosis or diabetes, they prevent about one coronary blood clot or one stroke per year. In the course of five years, about two deaths are avoided.

Many of the treated meanwhile develop heart failure, which is reduced pump function of the heart, because atherosclerosis damages the heart muscle permanently. They begin to complain of tiredness and increasing shortness of breath.

Is it risky to take cholesterol lowering pills in this situation? There can be debated. The debate is due to the way that the medicine works. It blocks the livers production of mevalonic acid, which is necessary for the production of cholesterol, but it also blocks the production of vital Q10! Not only does the blood’s cholesterol level fall, but also the bloods Q10 level.

Because Q10 is necessary for the tissues to create energy it is easy to imagine that a heart muscle which is weakened by heart failure, is further weakened when Q10 is removed.

Apparently statins work anyway. Statins are believed to lengthen life in heart failure. Not because they lower cholesterol, which may actually be damaging when suffering from heart failure, but because statins have other effects than reducing cholesterol. They are antioxidants and counteract inflammation. In addition they promote the creation of new blood vessels in the heart. None of these effects have anything to do with cholesterol.

Maybe the positive effects of statins outweigh the dramatic Q10 loss that they cause. Nonetheless, it is hard to believe that this loss is completely harmless, especially with heart failure.

The American cardiologist P.H. Langsjoen is one of those who warn that we find ourselves in an epidemic of heart failure with unclear reasons and who believe that statins could be one of the reasons.

At a congress in Los Angeles he put forth data which indicates previously unrecognised side effects. Two thirds of 51 newly referred statin treated patients complained of muscle pain, more than 80% were abnormally tired, and almost 60% had shortness of breath. When they stopped using statins and instead received Q10 (240 mg/day), most became symptom free.

At the same congress a randomised trial showed that muscle pain and tiredness was present in one out of every ten on those treated with statins, but disappeared when they took Q10 (100 mg/day). Just as important, more than half experienced an improved quality of life and many showed improved heart function.

Pills against cholesterol lengthen life, but it is necessary to take Q10 if quality of life also increases so that a longer life is a life worth living.

By: Vitality Council

References:
1. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: A randomised placebo-controlled trial. Lancet 2002;360:7-22.
2. Langsjoen PH et al. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors. 2003;18(1-4):101-11.
3. Liao JK. Statin therapy for cardiac hypertrophy and heart failure. J Investig Med. 2004 May;52(4):248-53.
4. Bandolier. Statins in heart faikure. http://www.jr2.ox.ac.uk/bandolier/booth/cardiac/statHF.html
5. Fourth Conference of the International Coenzyme Q10 Association. Los Angeles April 14-17 2005.

www.thelancet.com
www.iospress.nl/html/09516433.php
journalseek.net/cgi-bin/journalseek/journalsearch.cgi
www.jr2.ox.ac.uk/bandolier/booth/cardiac/statHF.html
www.coenzymeq10.it/home.html
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Cholesterol Medicine Halves the Amount of Coenzyme Q10 in the Blood

Claus Hancke

August 16, 2004

Heart specialists normally shrug off the suggested recommendation that patients treated with cholesterol lowering drugs must take Coenzyme Q10. While it is common knowledge that such medicine interferes with the body’s ability to create Coenzyme Q10, and that Q10 is essential for life, conventional medical thinking still holds that supplementation is superfluous because of the belief that medical treatment is effective and increases life span!

Now this conventional thinking is being challenged by new studies showing that one of the most commonly used cholesterol lowering medicines not only decreases but actually halves the amount of Coenzyme Q10 in the blood. This was shown in a study sponsored by the pharmaceutical giant Pfizer, the company behind the drug atorvastatin (Zarator). Atorvastatin is one of the most widely used cholesterol-lowering drugs.

Q10 is the well-known antioxidant, which is also necessary for the cells to produce energy. Q10 is produced in the organism, but it is also found in the diet, where beef, soy, mackerel, herring and sardines in particular are good sources. With age, the organism’s own production decreases, and the content of Q10 in the blood decreases.

The new study was conducted at Columbia University in New York at a center for patients with cerebral hemorrhage. Here, 34 patients had their Q10 levels in their blood measured before they were given atorvastatin. Just 14 days later, their Q10 levels in their blood had certainly decreased. After 30 days, it had been halved!

Even though no one noticed the change, it was so striking that the group behind the trial recommends routine supplementation with Q10 when treated with atorvastatin and other “statins.” This means that almost everyone who is being treated for high cholesterol is advised to take a supplement.

In a statement, it was said that the study explains the most common side effects of “statins”, namely muscle pain, muscle fatigue and reduced physical performance! Q10’s extensive lack of toxicity was highlighted as an additional reason to take it!

By: Vitality Council

Reference:
Rundek T, Naini A, Sacco R, Coates K, DiMauro S. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol. 2004;61(6):889-92.

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