Higher Dose ACE Inhibitor Better for Heart Failure: In 2-year follow-up of 298 adults with mild to moderate heart failure, worsening was observed for 31.5% on captopril 25 mg twice a day vs. 22.4% on 50 mg twice a day (p = 0.088). The higher dose showed fewer hospitalizations (22.4 to 14.5% (p = 0.1)) and fewer fatal and nonfatal cardiac events (22% (p = 0.142)). Dizziness and hypotension were a little more frequently reported in the high-dose group. Serum creatinine values showed no significant changes. Long-term effects of clinical outcome with low and high dose in the Captopril in Heart Insufficient Patients Study (CHIPS). Clement DL, De Buyzere M, et al. Gent, Belgium. Acta Cardiol. 2000 Feb;55(1):1-7.

Higher Dose ACE Inhibitor Fewer Heart Transplant Deaths: In a study of 237 heart transplantation candidates, those who, for whatever reason, received ACE-inhibitors below the recommended dosages (<75 mg captopril, 20 mg enalapril, 20 mg lisinopril, 5 mg ramipril/day), had an increased mortality risk (25% vs. 16%) and was the strongest predictor of mortality. ACE inhibitor dosage at the time of listing predicts survival. Berger R, Kuchling G, et al. University of Vienna, J Heart Lung Transplant. 2000 Feb;19(2):127-33

Both ACE Inhibitors and ARBs Help Prevent Diabetes: In two meta-analyses of clinical trials investigating the effect of the inhibition of the renin-angiotensin system either with an angiotensin converting enzyme inhibitor (ACEI) or with a selective angiotensin receptor blocker (ARB) on the incidence of new cases of type 2 diabetes mellitus in adults with arterial hypertension or with congestive heart failure, the protection appears similar with ACEIs in six trials in a total of 24.623 patients (hazard ratio: 0.77; p < 0.00001) and with ARBs in five trials in a total of 14.344 patients (hazard ratio: 0.79; p < 0.00001). It is consistent whatever the comparator, a thiazide diuretic agent, a beta-blocker, a dihydropyridine calcium channel blocker or a placebo. Similar reduction in new cases of type 2 diabetes with angiotensin receptor blocker and ACE inhibitor: comparison of meta-analyses of prospective randomised trials. Scheen AJ. Universite de Liege. Rev Med Liege. 2005 May-Jun;60(5-6):424-8

L-Carnitine Helps After Heart Attack: Early and long-term administration of L-carnitine attenuates progressive left ventricular dilatation after acute anterior MI. Results show significant, consistent reductions in end-diastolic volume and end-systolic volume in patients who received L-carnitine compared with placebo. DB multi-center Italian study. Am Heart J 2000 Feb;139(2 Pt 3):S124-30

L-Carnitine Helped Heart Failure: In a 3-year Greek DB study of 80 adults with 3 years of L-carnitine administration for heart failure caused by dilated cardiomyopathy with moderate to severe heart failure (New York Heart Association classification III to IV), there was a lower death rate with one carnitine death vs. six with placebo. Am Heart J 2000 Feb;139(2 Pt 3):S120-3 

CoQ10 Considerably Improves Survival in Heart Attacks Treated with Hypothermia: In a DB PC study of 49 heart attack victims, hypothermia plus CoQ10 150 mg t.i.d. had much better 3-month survival (68%) than hypothermia alone (29%) (P=0.0413). Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest. A Preliminary Study. Damian MS, Ellenberg D, et al., University Hospitals of Leicester, United Kingdom. Circulation. 2004 Nov 9;110(19):3011-6

CoQ10 Heart Failure Review Very Positive: This Copenhagen University review covers 13 controlled studies of over 1,000 patients and says that 10 of the 13 covering over 900 patients reported positive findings with the other three neutral. A large 550-patient 3 month study of CoQ10 100 mg three times a day has begun with plans for a 2 year follow-up. Overview on coenzyme Q_{10} as adjunctive therapy in chronic heart failure. Rationale, design and end-points of "Q-symbio" - A multinational trial. Mortensen SA. Biofactors. 2003;18(1-4):79-89 

CoQ10 Helps Angina: In a DB PC study of 12 patients averaging 56 years old who were treated for 4 week with CoQ10 150mg/day there was a decrease in the frequency of angina and the number of nitroglycerin tablets required as well as an increase in exercise tolerance. Kamikawa, Am J Cardiol 8/85;56:247 

CoQ10: Heart Attacks Cut in Half; Fatigue Markedly Reduced:  In a DB PC study of 144 heart attack patients started on 120 mg/day of CoQ10 within 3 days of the heart attack, large decreases in angina (10% vs. 28%), total arrhythmias (10% vs. 25%), poor left ventricular functioning (8% vs. 22%) and total cardiac events (15% vs. 31%) occurred over the next 28 days. After 1 year, total cardiac events (24.6 vs. 45.0%, p < 0.02) including non-fatal infarction (13.7 vs. 25.3%, p < 0.05) were much less with CoQ10. Lipid peroxidases, malondialdehyde, and diene conjugates, all indicators of oxidative stress, were lower with Q10. Vitamins A, C, E, and beta-carotene were all higher with Q10. Singh, Moradabad, Cardiovasc Drug Ther 9/1998;12:347; In another study, fatigue was markedly decreased: 7% vs. 40% Mol Cell Biochem. 2003 Apr;246(1-2):75-82

CoQ10 Not Help for Congestive Heart Failure in Very Small Study but Taurine Did: In a DB study, taurine 3g/day was compared to CoQ10 in 17 patients with CHF for 6 weeks. There was no benefit from Q10 but better left ventricular heart function with taurine. Azuma, Osaka U, Jpn Circ J ’92;56:95

CoQ10 Not Much Help in Congestive Heart Failure: The Swedish Q10 Study Group using a DB PC trial of 79 patients with half given CoQ10 100 mg/day for 3 months found only minimally improved quality of life and exercise tolerance. Hofman-Bang, Karolinska Inst, J Card Fail 3/95;1:101

CoQ10 Helped Patients Waiting Heart Transplant: In a DB PC study of 32 patients awaiting heart transplants, 60 mg U/day of CoQ10 (a special preparation to increase intestinal absorption) for 3 months led to significant improvement in the 6-min walk test and a decrease in dyspnea, New York Heart Association (NYHA) classification, nocturia, and fatigue. No significant changes were noted after 3 months of treatment in echocardiography parameters (dimensions and contractility of cardiac chambers) or ANF and TNF blood levels. Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study. Berman M, Erman A, Ben-Gal T, Dvir D, Georghiou GP, Stamler A, Vered Y, Vidne BA, Aravot D. Rabin Medical Center, Israel. Clin Cardiol. 2004 May;27(5):295-9.

CoQ10 Helps Heart Failure in Large DB: A large Italian 1 year DB PC study of 640 patients in stage III or IV congestive heart failure had CoQ10 2 mg/kg/d added to their regular medication or were given a placebo. The CoQ10 group had fewer hospitalizations (73 vs. 118), less cardiac asthma (97 vs. 198), and less pulmonary edema (20 vs. 53). Morisco, Clin Investig ’93;71(8 Suppl);S134. Ed: This large of a study is excellent and the benefits appear quite impressive. 

Taurine Helped Congestive Heart Failure: In a DB PC crossover study, 14 patients were given 4 weeks each of a placebo or 6 mg/day of taurine. No side-effects were noted from the taurine. Improved New York Heart Association functional class (p<0.02), pulmonary crackles (p<0.02), and chest film abnormalities (p<0.01) were documented during the taurine treatment. A benefit of taurine over placebo was demonstrated when an overall treatment response for each patient was evaluated on the basis of clinical examination (p<0.05). No patient worsened during taurine administration, but four patients did during placebo. Therapeutic effect of taurine in congestive heart failure: a double-blind crossover trial. Azuma J, Sawamura A, et al. Clin Cardiol. 1985 May;8(5):276-82. Taurine is found in very high concentration in the mammalian heart. Because chronic myocardial taurine loss produces myocardial injury, taurine may be beneficial. 

People with severe CHF who took spironolactone, a decades-old diuretic, plus their normal drug regimen had a 30% lower risk of death after two years than those who took placebo.

Animal Research

Melatonin: Protects Heart and Lungs Against Fungal Toxin: Protective role of melatonin in ochratoxin a toxicity in rat heart and lung. Okutan H, Aydin G, Ozcelik N. J Appl Toxicol. 2004 Nov-Dec;24(6):505-12

Melatonin Protected Heart Against Cancer Drugs: Effect of melatonin on the cardiotoxicity of doxorubicin. Balli E, et al. Histol Histopathol. 2004 Oct;19(4):1101-8. Melatonin protects the heart against ischaemia-reperfusion injury and also against cardiotoxic effects of adriamycin and alloxan. Lack of melatonin was repeatedly reported in patients with coronary heart disease. Intake of this hormone leads to decrease of blood pressure in normotensive and hypertensive subjects, while pinealectomy induces hypertension. Vazan R, Beder I, Styk J. Cesk Fysiol. 2004;53(1):29-33; Similar, earlier report on adriamycin by Kocak, et al. Turkey. Can J Cardiol. 2003 Apr;19(5):535-41.

Melatonin Prolongs Cardiac Transplant Survival in Rats: Jung FJ, et al. University Hospital Zurich, Zurich, Switzerland J Pineal Res. 2004 Aug;37(1):36-41

Melatonin Protects Mice and Rats Against Myocardial Infarction. Either pretreatment or at time of induced heart attack. Chen Z, et al. East Tennessee State University. Am J Physiol Heart Circ Physiol. 2003 May;284(5):H1618-24; Also, protects rats against ischemia/reperfusion injury. YM Lee et al. J Pineal Res. 2002 Sep;33(2):72-80.

Melatonin Reverses Urinary System and Aorta Damage in the rat due to Chronic Nicotine administration. Sener G, et al. Marmara University, Istanbul, Turkey. J Pharm Pharmacol. 2004 Mar;56(3):359-66

Melatonin Better than Lipoic Acid, Vitamins C and E, and Fish Oil for MDA and Homocysteine: Malondialdehyde (MDA) levels decreased in melatonin (p <0.01), lipoic acid (p <0.01), and vitamin E (p <0.05) groups but not significantly with vitamin C and VC6OP (p >0.05) and fish oil supplementation caused an insignificant increase in rats. Plasma lipid levels in animals treated with melatonin, vitamin E, vitamin C, lipoic acid, and fish oil were significantly lower than  controls; melatonin and fish oil significantly lowered homocysteine levels. Firat Univ. Turkey. Arch Med Res. 2002 Nov-Dec;33(6):515-9.

Melatonin Protects Against Myocardial Injury of Isoproterenol in Rats: Acikel M, et al. Ataturk University. J Pineal Res. 2003 Sep;35(2):75-9

Melatonin: Atherosclerosis Increased in Aorta in One Study, But Not Another: Daily melatonin supplementation in hypercholesterolemic mice increases atherosclerosis in proximal aorta. Tailleux A, et al. Institut Pasteur, Lille, France. Biochem Biophys Res Commun. 2002 May 10;293(3):1114-23; However, in another study, a trend toward decreased cholesterol levels in the aorta was found with definite decreases in the liver and plasma. J Pineal Res. 2004 Apr;36(3):212-