Widespread Use of Statin Drugs May Deplete CoQ10, Increase Heart Failure Risk
by Jack Challem
Dramatic increases in the incidence of congestive heart failure may be partly related to the widespread use of "statin" cholesterol-lowering drugs, including Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Zocor (simvastatin). That's the conclusion of a recent article in the journal BioFactors by Peter H. Langsjoen, MD, affiliated with the East Texas Medical Center in Tyler, Texas.
From 1968 to 1993, the number of U.S. deaths directly attributed to congestive heart failure increased from 10,000 to 42,000 cases annually. From 1970 to 1994, the rate of hospitalizations for heart failure increased by more than three times. And in a study at the Henry Ford Heart and Vascular Institute, Detroit, cases of heart failure doubled from 1939 to 1997, according to research cited by Langsjoen.
Statin drugs, introduced in 1987, have been widely prescribed for reducing elevated levels of low density lipoprotein (LDL) cholesterol.
However, according to Langsjoen, numerous human and animal studies have shown that statin drugs interfere with the body's production of coenzyme Q10, a vitamin-like antioxidant involved in cellular energy production and normal heart-muscle fuction. Heart cells in particular have very high energy and CoQ10 requirements.
"Statin-induced depletion of CoQ10 must be considered in the ...epidemic of heart failure," he wrote.
CoQ10, which was the basis of the 1972 Nobel Prize in chemistry, plays a key role in the production of the chemical form of energy, adenosine triphosphate (ATP). Previous research has documented deficiencies of CoQ10 in patients with congestive heart failure.
Many of those studies have found substantial decreases in blood and tissue CoQ10 levels after therapy with statin drugs. The drugs reduce the activity of HMG-CoA reductase, an enzyme involved in the body's production of both cholesterol and CoQ10. By reducing CoQ10 production in the body, statins also lower levels of ATP, which can impair normal heart function.
"In human trials evaluating CoQ10 in statin therapy, there appears to be frequent and significant depletion in blood CoQ10 levels, particularly when statins are taken at higher doses and most notably in the elderly," Langsjoen wrote.
In one study, patients taking 20 mg of Zocor for six months had decreased levels of both LDL cholesterol and CoQ10. But patients who took 100 mg of CoQ10 along with Zocor were able to lower their cholesterol without lowering levels of the nutrient.
As physicians continue perscribing higher dosages of statin drugs, combined with more aggressive efforts to lower LDL cholesterol, "the severity of CoQ10 depletion will increase with an increasing likelihood of impairment in heart-muscle function," Langsjoen concluded.
- Langsjoen PH, Langsjoen AM. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. BioFactors, 2003;18:101-111.
Copyright 2004, Jack Challem
Reprinted with permission
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