The importance of mitochondrial function in meeting the energy needs of the heart has been emphasized recently because of the increasing tendency for congestive heart failure (CHF) in statin drug users.
Statin drugs in their role as HMG CoA reductase inhibitors of the critical mevalonate pathway, must inevitably curtail the availability of ubiquinone, vital to mitochondrial function.and energy production.
Ubiquinone fueled mitochondria exist to meet the energy needs not only of the heart but also of every cell in the body. Although the heart tends to show effects of mitochondrial deficiency early because of its extraordinary requirement to do work, every cell and every tissue in our body is equally dependent upon the energy supply of mitochondria for function.
This entire energy generating process is ultimately dependant upon abundant reserves of ubiquinone, the same offspring of the mevalonate pathway critically curtailed by statin drugs. Simple logic dictates that the statin drug impact on ubiquinone availability and mitochondrial energy production is profound.
In addition to the critically important role of ubiquinone in energy production, it has a possibly even greater role within the mitochondria as a powerful anti-oxidant. We must remember that mitochondria are in immediate contact with oxygen, front line warriors so to speak in struggle to obtain life giving oxygen without sustaining excessive oxidative damage. The inevitable result of excessive free radical accumulation is an increase in the rate of mitochondrial mutations.
Only in the past two decades have investigators learned that the result of mutations in mitochondrial DNA cause or contribute to a wide range of disorders. Genetic injury in mitochondria is now suspected to play a role in the aging process and in the chronic degenerative diseases which we encounter in later life.
Ongoing research fully documents the reality that our energy production declines and somatic mitochondrial DNA mutations increase as we grow older. In the absence of sufficient ubiquinone this entire process is speeded up. The obvious inference is that an inevitable consequence of widespread statin use will be aggravation of the very factors those in preventive medicine are trying to modulate.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor