CoQ10 is vital for producing ATP, the cell’s fundamental energy carrier. Insufficient CoQ10 inhibits ATP production, resulting in an energy deficit that the review authors say “could be a major cause for heart muscle and coronary artery damage.”

Coronary calcification happens when calcium accumulates in the walls of the coronary arteries, which provide oxygen to the heart. This plaque buildup is a sign of early coronary artery disease, which can block blood flow and trigger a heart attack.

Statins also damage selenoproteins, carriers of the mineral selenium, which is essential for heart health.

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Doctors prescribing cholesterol drugs “cannot ignore the moral responsibility of ‘informed consent,’” the researchers wrote, noting that patients deserve full disclosure of side effects such as cardiovascular disease and heart failure.

With more than 1 million annual heart failure hospitalizations in the United States, the condition is often referred to as an epidemic—and, according to the review, it may be that “statin drug therapy is a major contributing factor.”