Major cardiovascular, metabolic, and hypertension outcomes of coenzyme Q10 supplementation in elderly patients: a systematic review and meta-analysis

Abstract

Introduction: The aging of the world's population poses unprecedented challenges to maintaining the health of the 9.1 billion people who will inhabit the planet by 2050. Dietary habits, which lead to the development of cardiovascular and metabolic diseases, significantly increase the risk of death. Objective: This was to conduct a systematic review to present and correlate the main outcomes of clinical studies on the dosages and bioavailability of coenzyme Q10, in monotherapy or associated with other supplements, for the best treatment and prevention of cardiovascular and metabolic diseases and arterial hypertension in the elderly. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from January to April 2026 in the Web of Science, Scopus, Embase, PubMed, ScienceDirect, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE and AMSTAR-2 instruments and the risk of bias was adequately analyzed, according to the Cochrane instrument. Results and Conclusion: A total of 154 articles were found, and 37 articles were fully evaluated and included in this article, of which 17 were included in the systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 29 studies that did not reach GRADE. Most studies presented homogeneity in their results, with X2=64.5%>50%. It was concluded that supplementation with selenium and coenzyme Q10 for an elderly population significantly reduces systemic oxidative stress, with a reduction in the risk of cardiovascular mortality and presenting a lower rate of cardiovascular mortality after a median follow-up of 10 years. There was also preservation of leukocyte telomeres, fibrosis reduction, and fibroblast growth factor 23 after selenium and Coenzyme Q10  supplementation. In patients with metabolic syndrome, nutraceutical (NC) and Coenzyme Q10 supplementation were safe, well tolerated, and effective in improving clinical blood pressure, lipid, and glycemic profiles. The combination of nutraceuticals and Coenzyme Q10  demonstrated clinical efficacy in reducing total cholesterol, non-HDL, LDL, and triglycerides, while improving the level of hepatic transaminases and high-sensitivity C-reactive protein.