Selenium + CoQ10 supplements may slash cardiovascular mortality: RCT

Four years of supplementation with 200 mg/day of coenzyme Q10 plus 200 micrograms per day of organic selenium yeast was also associated with significant improvements in cardiac function, according to findings published in the International Journal of Cardiology​​.​

Researchers from Linköping University and the Karolinska Institutet suggest that the effects of the supplements may be synergistic since selenium is essential for the activity of selenoproteins, including TrxR1 which is said to be vital for the efficacy of CoQ10.

Selenium intakes are below the optimal levels in Scandinavia because selenium levels in the soil are low (and selenium levels in crops are therefore lower than the US, for example). Therefore, selenium supplements would improve TrxR1 activity, which in turn would improve the efficacy of CoQ10.

"Results that cannot be ignored"​

Commenting on the study, Cara Welch, PhD, VP of scientific & regulatory affairs for the Natural Products Association (NPA) told NutraIngredients-USA that it was a small but well-designed study with "results that cannot be ignored”.​

Dr Welch added that not only did the study demonstrate that selenium plus CoQ10 significantly reduced the chance of cardiovascular death, but the observed reduction of levels of a cardiac biomarker and echocardiographic measurements even hinted at a possible mechanism of action.

"I look forward to seeing further studies to support the use of selenium and coenzyme Q10 for improved cardiovascular health.”​

Hitting the high points​

Duffy MacKay, ND, VP of scientific & regulatory affairs for the Council for Responsible Nutrition (CRN), said that this is the type of evidence that the industry needs to be producing to show how nutrition contributes to health and wellness, and he commended the researchers and the sponsors for the study.

“Not only is this well done but it also hits a lot of the high points where nutrient studies can be criticized,”​ he said. “They used a very well characterized material with well documented bioavailability, and they tested a strong hypothesis. ​

“They also chose a target population [healthy seniors] where they were likely to see a result. The only downside to seniors is that they are hard to keep in the study and the study had a significant dropout of about 50% in both groups. ​

“This study creates a nice set of evidence for other researchers to build on.”​

Study details​

The Swedish researchers, led by Urban Alehagen, MD, PhD, investigated the ‘vital relationship’ between the two substances in a randomized double-blind placebo-controlled trial with 443 Swedish citizens aged between 70 and 88 (228 participants completed the study).

Participants were randomly assigned to receive either 200 mg per day of coenzyme Q10 capsules (Bio-Quinon, Pharma Nord, Denmark) and 200 micrograms per day of organic selenium yeast tablets (SelenoPrecise, Pharma Nord, Denmark), or similar placebo for 48 months.

Results showed that 12.6% of people in the placebo group died of cardiovascular disease, compared with only 5.9% in the selenium plus CoQ10 group, producing a decrease in absolute risk of 6.7%.

In addition, the biomarker of tension in the heart wall called N-terminal proBNP (NT-proBNP) was also significantly lower in the supplement group, compared to placebo, said the researchers.

Data from echocardiography also revealed a “significant better cardiac function score was found in the active supplementation compared to the placebo group”​.

“This study investigates for the first time the interrelationship between selenium and coenzyme Q10 and the compounds have been used in a therapeutic purpose to affect the [cardiac wall cells],”​ wrote Alehagen and his co-workers.

“We suggest that the results of this study can provide a basis for extended analyses of the effects of selenium/coenzyme Q10 on various conditions, and that further supplementation studies in larger populations involving diverse age groups should be initiated.”​

The study was supported by Pharma Nord Aps, Denmark, the County Council of Östergötland, Linköping University, and the Swedish Research Council. Pharma Nord Aps also donated the selenium tablets and coenzyme Q10 capsules..

Importance​

Selenium is an essential macronutrient, and is considered to be an antioxidant. High levels of selenium have been inversely associated with risk of developing several cancers, including bladder, prostate and thryroid.

The mineral is included in between 50 and 100 different proteins in the body, with multifarious roles including building heart muscles and healthy sperm. However, cancer prevention remains one of the major benefits of selenium, and it is the only mineral that qualifies for a Food and Drug Administration (FDA)-approved qualified health claim for general cancer reduction incidence.

A recent review paper by Joyce McCann and Bruce Ames​ from the Nutrition and Metabolism Center at Children’s Hospital Oakland Research Institute in Oakland (CHORI) indicated that moderate deficiency in selenium may have long-term detrimental effects (FASEB Journal​, 2011, Vol. 25, pp. 1793-1814).

CoQ10 – or coenzyme Q10 plays a vital role in the production of chemical energy in mitochondria – the 'power plants' of the cell – by participating in the production of adenosince triphosphate (ATP), the body's co-called 'energy currency'.

It has been studied for its role in cognitive health, heart health, and anti-aging (in oral and topical formulations). It has also been shown to benefit those suffering from angina, heart attack and hypertension.

Source: International Journal of Cardiology​​
Volume 167, Number 5, Pages 1860–6. doi: 10.1016/j.ijcard.2012.04.156​ 
“Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: A 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens”​
Authors: U. Alehagen, P. Johansson, M. Bjornstedt, A. Rosen, U. Dahlstrom