Coenzyme Q 10 (CoQ10) is important for energy production in cells. This role in energy production is especially important in cells with high energy demands such as heart muscle cells. CoQ10 also acts as a powerful anti-oxidant. CoQ10 reduces the oxidation of LDL ("bad cholesterol") that precedes a heart attack. CoQ10 deficiency in heart and blood tissue has been documented in congestive heart failure.

The statin drugs were introduced in 1987 to reduce cholesterol levels. There have been a number of studies since 1990 that have demonstrated significant CoQ10 depletion secondary to the use of statin drugs to lower cholesterol levels, especially at higher doses of statins and in the elderly. It has been shown that the statins reduce CoQ10 levels by reducing the body's own production of CoQ10. CoQ10 levels are also known to drop steadily after age 40. In the years since the introduction of statin drugs, the US has experienced a huge increase in cases of congestive heart failure. Some researchers feel that the increase in congestive heart failure cases is at least in part due to the use of statin drugs.

CoQ10 is sold in the US as a dietary supplement. It has been the subject of over 1,000 clinical trials and has been shown to be remarkably safe with no known serious side effects and mild nausea only rarely reported. In one long-term study (6 years) of CoQ10 supplementation, investigators found no side effects and significant reductions in hospitalizations for heart failure. Studies have demonstrated that supplementation with CoQ10 increases CoQ10 levels without affecting the cholesterol-lowering effects of statins. It is felt by some researchers that all prescribing doctors should be notified that statin medications lower CoQ10 levels and that, in cases of pre-existing CoQ10 deficiencies such as congestive heart failure and in the elderly, they could markedly worsen heart function. They recommend that CoQ10 supplementation at 100 mg to 200 mg per day should accompany statin use in all such cases to reduce the risk of statin-induced cardiomyopathy. Some researchers have gone so far as to recommend that all statin medications should have a black box warning that states that all patients taking these medications should be advised to take 100 mg to 200 mg of CoQ10 daily. Patients taking statin medications, especially those over 40 years old and those at risk for congestive heart failure, should talk to their doctors about supplementing CoQ10 at 100 mg to 200 mg per day.

Reference: http://www.fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf.

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