Category: Cardiovascular disease

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Selenium Status and Cardiovascular Diseases

What is selenium’s effect on cardiovascular disease risk?
Vegetables as part of a healthy diet
In regions with poor selenium content in the soil and the crops, eating a healthy diet may not ensure an optimal selenium nutritional status.

Chen et al say that “oxidative stress, redox signaling, endothelial activation, and inflammation contribute to atherosclerosis and myocardial injury”. So, there is a mechanistic rationale for selenium to have a cardioprotective effect. “Selenium-dependent enzymes provide a plausible connection because glutathione peroxidases and thioredoxin reductases participate in peroxide reduction and redox regulation” [Chen 2026].

Are selenium status and cardiovascular disease related?

Generally, observational studies show low selenium status associated with increased risk of cardiovascular diseases. However, interventional studies have not shown clearly that selenium supplementation reduces the risk of cardiovascular diseases [Chen 2026].

Chen et al analyzed the relevant research for the period 2005-2026. They concluded that there is not enough evidence to support a program of universal selenium supplement for protection against cardiovascular disease [Chen 2026]. read more

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Selenium and Inflammation in Heart Disease

Does selenium status affect biomarkers of inflammation in patients with heart disease?
Senior citizens
The KiSel-10 study showed that senior citizens low in selenium had higher levels of biomarkers of inflammation. Combined selenium and Coenzyme Q10 supplementation reduced their risk of mortality from heart disease.

In a 2026 Norwegian study, researchers examined and compared epicardial adipose tissue biopsies from two groups of heart disease patients [Opstad 2026]:

  • Coronary artery disease patients undergoing coronary artery bypass grafting (n = 52)
  • Heart valve disease patients receiving valve replacement (n = 22)

The heart valve disease patients had lower vulnerability to elevated inflammation levels. As such, they served as a control group to the group of coronary artery disease patients.

The research team obtained the epicardial adipose tissue biopsies during open-chest heart surgery. They measured selenium concentrations in the blood circulation and in the epicardial adipose tissue of the heart disease patients.

Epicardium and epicardial adipose tissue
Question: What is the epicardium?

The Cleveland Clinic explains that the epicardium is the outer layer of the heart muscle and the inner layer of the pericardium that surrounds the heart. A layer of fat (= adipose tissue) separates the epicardium from the heart muscle. The epicardium protects the heart and helps the heart function [Cleveland Clinic staff 2025]. read more

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Selenium and Coenzyme Q10 – A Good Heart Health Combination?

What makes selenium and Coenzyme Q10 a good heart health combination supplement? Here, of course, we are talking about supplementation of individuals who have low selenium and CoQ10 blood levels.

Dr. Jan Alexander, Norwegian selenium researcher
Guest author Dr. Jan Alexander, MD, Ph.D., has been the co-author of the selenium scoping article [Alexander and Olsen 2023] for the 2023 Nordic Nutrition Recommendations and several KiSel-10 sub-studies.
How much selenium is enough? How much Coenzyme Q10 is enough? Roughly estimated, individuals with serum selenium levels below 80 mcg/L may need more selenium than they are getting in their diets. The same estimate applies to individuals with plasma CoQ10 levels below 0.8 mg/L. The goal of the selenium supplementation is to raise the circulating selenium levels to approximately 110-125 mcg/L [Alexander and Olsen 2023, Larsen 2024]. The purpose of the CoQ10 supplementation is to raise the circulating CoQ10 levels to about 2.5 mg/L [Langsjoen 2014]. read more

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Selenoprotein P and Heart Health

Low serum concentrations of selenoprotein P (SELENOP) are an indication of increased heart health risks. Low serum SELENOP is strongly associated with the following risks:

  • increased risk of a first cardiovascular event
  • increased risk of cardiovascular mortality
  • increased risk of all-cause mortality 
Scene from Scandinavia - a selenium-poor region.
Selenium is a scarce resource. It is a non-renewable resource. Selenium deficiency is a health problem for one half to one billion people in the world. The UK, the Nordic countries, and the Baltic countries are among the selenium-poor regions in the world.

This is the conclusion from a relatively large study of adults in Sweden. The study participants had no history of cardiovascular disease at the beginning of the study [Schomburg 2019].

There were 3,531 non-smokers and 835 smokers enrolled in the study in Sweden. At the end of the study, the study participants at increased risk of cardiovascular disease had a mean serum SELENOP level below 4.3 mg/L SELENOP. This serum concentration of SELENOP corresponds to serum selenium concentrations of less than 70 mcg/L [Schomburg 2019]. read more

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Selenium and the Risk of Heart Disease

The association between the risk of heart disease and dietary intakes of selenium remains unclear. Here we report the results of some of the recent observational studies on this topic.

Risk of Cardiovascular Disease

Statue of Liberty
Plasma selenium levels are generally low in much of Europe, usually well below 80–90 mcg/L whereas in North America, the levels are generally above 120 mcg/L [Alehagen 2022]. Low selenium status is associated with increased heart disease risk.
In 2025, Liang et al investigated the relationship between the risk of cardiovascular disease and dietary selenium intake in American adults. The researchers used data from 39,372 participants in the 2003-2018 NHANES cross-sectional study. They found an overall prevalence of cardiovascular disease of 8.57% in the participants. The prevalence of cardiovascular disease declined with increasing dietary selenium intake across tertiles. For example, Tertile 2 of dietary selenium intake showed a 16% reduced risk of cardiovascular disease [Liang 2025]. read more

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Selenium and Good Health

Selenium is an essential trace element for good health. If we are to survive and reproduce, we need some selenium in our diets. Not much but some. The reason is that our bodies cannot synthesize the selenium we need. Many of us live in a region of the world with low selenium content in the soil and in the regionally grown food products. Accordingly, it is difficult for us to get enough selenium in our diet.

Selenium researcher Dr. Jan Alexander
Dr. Jan Alexander (M.D., Ph.D.) is co-author on several KiSel-10 studies and co-author of the selenium scoping review for the 2023 Nordic Nutrition Recommendations.

For example, Alexander et al point out that mainland Europe and Scandinavia are regions with a low intake of selenium. North America, by contrast, is a region with much higher selenium intake. There is considerable variation in the selenium content of locally cultivated food products around the world. Consequently, daily selenium intake varies considerably. Depending upon the region we live in, we may be at risk of sub-optimal selenium intakes or selenium deficiency [Alexander 2024]. read more

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Selenium and Heart Failure and Immune Function

Selenium has beneficial effects on the prevention and treatment of heart failure. Higher serum selenium levels are associated with a lower risk of new-onset heart failure and with a lower risk of mortality. Now, data from a 2024 cohort study suggest that strengthened immune system function may be a mechanism that explains the positive effect of selenium [Al Mubarak 2024].

Depiction of human heart
Good heart health depends in part on adequate intake of selenium. Serum selenium status below 70 mcg/L connotes deficiency status. Selenium status below 100 mcg/L is sub-optimal status. The best estimate is that serum selenium status should be in the range of 125-135 mcg/L.

In the study, Al Mubarak et al analyzed the data from a cohort of 2,328 patients diagnosed with heart failure. Heart failure is the medical term to describe patients with a heart muscle that cannot pump as much blood out to the tissues and organs as it should. The heart is too weak or too stiff to fill up with blood and pump out blood optimally. Heart failure is frequently associated with a build-up of fluid in the lungs – causing shortness of breath – and in the lower extremities. The bottom line is that heart failure can be life-threatening [Mayo Clinic Staff 2025]. read more

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Selenium and Heart Failure

Heart failure is a condition in which the heart no longer performs as well as it should. It affects millions of people in the United States and Europe. Heart failure is characterized by the following symptoms:

• shortness of breath
• build-up of congestion in the lungs
• accumulation of fluid in the lower extremities

What do we know about selenium status and the risk of heart failure?

Prof Urban Alehagen selenium and heart disease researcher
Prof Urban Alehagen’s KiSel-10 studies and sub-analyses have shown that selenium supplementation of elderly citizens low in selenium reduces the risk of heart disease mortality.

Low serum selenium levels are associated with increased risk of heart failure [Al-Mubarak 2021; Bomer 2020].

  • Selenium status below 70 mcg/L is regarded as selenium deficiency status [Al-Mubarak 2021; Bomer 2020].
  • Selenium status below 100 mcg/L is regarded as suboptimal status [Al-Mubarak 2021; Bomer 2020].
  • Both selenium deficiency and suboptimal selenium status are associated with increased risk of cellular dysfunction, oxidative stress, and chronic low-grade inflammation [Al-Mubarak 2021; Bomer 2020].

    • What do we know about selenium supplementation and heart failure?

    • Selenium supplementation of individuals with low selenium status may improve heart function and may reduce the need for hospitalization [Alehagen 2022].
    • Selenium supplementation of individuals with low selenium status may reduce the oxidative stress and systemic inflammation that increase the risk of heart failure [Alehagen 2022].

    Selenium and the Risk of Cardiomyopathy

    Myocardium is the medical term for the heart muscle. Cardiomyopathy is a disease or disorder of the heart muscle, often of unknown cause. Keshan disease is a form of cardiomyopathy that develops as a result of selenium deficiency and exposure to a strain of the coxsackievirus. The disease takes its name from Keshan County in northeastern China Its symptoms were first observed there. Keshan disease can result in heart failure [Zhou 2018]. read more

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    Selenium and Heart Disease

    Heart disease. The evidence from clinical studies is increasing. Selenium deficiency is associated with an increased risk of heart trouble [Bomer 2020]. Selenium supplementation of elderly individuals who have low selenium status is associated with improved survival, improved heart function, and improved quality of life [Alehagen 2013].

    Map of Europe
    Selenium intakes and selenium status in countries in northern Europe are generally quite low. Consequently, clinical trials conducted in northern Europe tend to be more valuable than clinical trials conducted in the USA where dietary selenium intakes are considerably higher for the most part.

    Especially in northern Europe, clinical studies show the relationship between the need for selenium and the risk of heart disease. This makes sense because the dietary selenium intake in northern Europe is considerably lower than the dietary selenium intake in much of the United States. Consequently, the mean plasma selenium concentrations in Europe tend to be well below 80–90 mcg/L. In the USA, on the other hand, the mean plasma selenium concentrations are generally above 120 mcg/L [Alehagen 2022]. read more

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    Heart Failure Risk and Selenium Deficiency

    Low plasma selenoprotein P levels are associated with a higher risk of heart failure in a Swedish population [Jujic 2023].

    Heart rate
    Selenium deficiency in heart failure patients is significantly associated with increased risk of cardiovascular mortality, impaired exercise capacity, and poorer quality of life [Bomer 2020].
    Selenoprotein P is the primary protein transporter of selenium in the blood.

    Plasma and serum selenoprotein P concentrations are useful biomarkers of selenium status in individuals with relatively low selenium intakes because selenoprotein P responds to different intake forms of selenium [Hurst 2010].

    Selenium deficiency – defined as serum selenium concentrations below 70 mcg/L – has been associated with more severe symptoms of heart failure, poorer exercise capacity, and poorer quality of life. Sub-optimal serum selenium concentrations of 70–100 mcg/L have similar adverse associations, suggesting that values less than 100 mcg/L, might be considered abnormal [Bomer 2020]. read more