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Cochrane Database of Systematic Reviews

Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension

Information

DOI:
https://doi.org/10.1002/14651858.CD007435.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 03 March 2016see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Hypertension Group

Copyright:
  1. Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Meghan J Ho

    Correspondence to: Faculty of Medicine, University of British Columbia, Vancouver, Canada

    [email protected]

  • Edmond CK Li

    Anesthesiology, Perioperative Medicine and Pain Management, University of Saskatchewan, Saskatoon, Canada

  • James M Wright

    Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada

Contributions of authors

James Wright and Meghan Ho jointly formulated the idea for the review, developed the basis for the protocol, interpreted the findings and wrote the final version of the review.
Meghan Ho took the lead role in searching, identifying and assessing studies, in data extraction and analyses, and in writing the first draft of the review.
Edmond Li assisted in identifying trials for the updated review and in interpretation of findings, independently assessed studies for inclusion, data extraction and risk of bias, as well as contributed to the figures, tables, and final draft of the review.

Sources of support

Internal sources

  • University of British Columbia, Department of Anesthesiology, Pharmacology & Therapeutics, Canada.

External sources

  • Canadian Institutes of Health Research, Canada.

Declarations of interest

None known.

Acknowledgements

The authors would like to acknowledge the help provided by the Cochrane Hypertension Group.

The authors would like to acknowledge the contribution of Anthony Bellusci, co‐author on a previous version of this review, who assisted in identifying trials for the initial published review, independently assessed studies for inclusion, and independently extracted data.

Version history

Published

Title

Stage

Authors

Version

2016 Mar 03

Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension

Review

Meghan J Ho, Edmond CK Li, James M Wright

https://doi.org/10.1002/14651858.CD007435.pub3

2009 Oct 07

Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension

Review

Meghan J Ho, Anthony Bellusci, James M Wright

https://doi.org/10.1002/14651858.CD007435.pub2

2009 Jul 08

Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension

Protocol

Meghan J Ho, Anthony Bellusci, James M Wright

https://doi.org/10.1002/14651858.CD007435

Differences between protocol and review

For the 2009 version of this review, the study acceptance criteria was modified to "Participants must have a baseline blood pressure of at least 140 mmHg systolic or a diastolic blood pressure of at least 90 mmHg." In the 2008 protocol, the minimum systolic blood pressure required was 160 mmHg. The intervention was changed to "therapy with coenzyme Q10 compared to a placebo control, either as the sole antihypertensive therapy or added to current antihypertensive medication" from "monotherapy with coenzyme Q10 compared to a placebo" in the protocol.

In this first update of the review (2016), the following amendment to the intervention criteria was added: "current anti‐hypertensive medication regimen that remains unchanged throughout the study."

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

PRISMA Study flow diagram
Figures and Tables -
Figure 1

PRISMA Study flow diagram

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Coenzyme Q10 vs Placebo: Clinic data, outcome: 1.1 Mean difference in SBP.
Figures and Tables -
Figure 3

Forest plot of comparison: 1 Coenzyme Q10 vs Placebo: Clinic data, outcome: 1.1 Mean difference in SBP.

Forest plot of comparison: 1 Coenzyme Q10 vs Placebo: Clinic data, outcome: 1.2 Mean difference in DBP.
Figures and Tables -
Figure 4

Forest plot of comparison: 1 Coenzyme Q10 vs Placebo: Clinic data, outcome: 1.2 Mean difference in DBP.

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 1 Mean difference in SBP.
Figures and Tables -
Analysis 1.1

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 1 Mean difference in SBP.

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 2 Mean difference in DBP.
Figures and Tables -
Analysis 1.2

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 2 Mean difference in DBP.

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 3 Mean difference in HR.
Figures and Tables -
Analysis 1.3

Comparison 1 Coenzyme Q10 vs Placebo: Clinic data, Outcome 3 Mean difference in HR.

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 1 Mean Difference in SBP.
Figures and Tables -
Analysis 2.1

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 1 Mean Difference in SBP.

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 2 Mean Difference in DBP.
Figures and Tables -
Analysis 2.2

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 2 Mean Difference in DBP.

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 3 Mean Difference in HR.
Figures and Tables -
Analysis 2.3

Comparison 2 Coenzyme Q10 vs Placebo: 24 hr BP measurements, Outcome 3 Mean Difference in HR.

Coenzyme Q10 compared with placebo for primary hypertension

Patient population: patients with primary hypertension

Settings: primary care in Japan and New Zealand

Intervention: coenzyme Q10 100 to 200 mg daily

Comparison: placebo

Outcomes

Mean difference in BP mmHg

[95% CI]

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

End of treatment SBP

(over 12 weeks)

‐3.7 mm Hg

(‐8.9 to 1.5)

50

(2)

⊕⊕⊕⊝
moderate1

End of treatment DBP

(over 12 weeks)

‐2.0 mm Hg

(‐4.8 to 0.8)

50

(2)

⊕⊕⊕⊝
moderate1

Withdrawals due to adverse effects

30

(1)

Effect estimate not available; only one study reported this outcome but had no events in either study arm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1. Downgraded due to large confidence intervals from a small sample size and small number of included studies.

Figures and Tables -
Comparison 1. Coenzyme Q10 vs Placebo: Clinic data

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean difference in SBP Show forest plot

2

50

Mean Difference (Fixed, 95% CI)

‐3.68 [‐8.86, 1.49]

2 Mean difference in DBP Show forest plot

2

50

Mean Difference (Fixed, 95% CI)

‐2.03 [‐4.86, 0.81]

3 Mean difference in HR Show forest plot

1

Mean Difference (Fixed, 95% CI)

Subtotals only

Figures and Tables -
Comparison 1. Coenzyme Q10 vs Placebo: Clinic data
Comparison 2. Coenzyme Q10 vs Placebo: 24 hr BP measurements

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean Difference in SBP Show forest plot

1

Mean Difference (Fixed, 95% CI)

Subtotals only

2 Mean Difference in DBP Show forest plot

1

Mean Difference (Fixed, 95% CI)

Subtotals only

3 Mean Difference in HR Show forest plot

1

Mean Difference (Fixed, 95% CI)

Subtotals only

Figures and Tables -
Comparison 2. Coenzyme Q10 vs Placebo: 24 hr BP measurements