Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension.

Systematic review/meta-analysis of randomized trials in adults with essential hypertension, including one study in patients with metabolic syndrome and one study that allowed type 2 diabetes-related entry criteria. Most participants continued their existing antihypertensive regimen; studies were conducted in clinical trial settings and included both parallel and crossover designs.

Oral coenzyme Q10 was evaluated as monotherapy added to usual care in adults with hypertension. Doses ranged from 100 mg/day to 200 mg/day, given in divided doses in some trials, for 10 to 12 weeks; comparator arms were placebo or clinic-data controls in the included trials.

Coenzyme Q10 did not produce a clinically significant reduction in blood pressure. For clinic measurements at end of treatment, the pooled effect was SBP MD -3.7 mm Hg (-8.9 to 1.5) and DBP MD -2.0 mm Hg (-4.8 to 0.8); 24-hour ambulatory BP also showed no effect (SBP MD -0.40 [-5.30, 4.50]; DBP MD -0.50 [-3.83, 2.83]). A reduction in clinic heart rate was reported in one trial (MD -4.80 [-9.31, -0.29]), but this was not corroborated by other measures. CoQ10 appeared well tolerated, with no significant adverse effects reported.

The evidence base was small, with only a few trials and limited total sample size. Several studies were short duration and included crossover or clinic-data analyses, which limits certainty and generalizability. Ambulatory blood pressure data were available from only one trial, and dose-response conclusions remain uncertain.