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Cocoa May Fight Hypertension
Published Wednesday, August 1, 2007

COLOGNE, Germany - Consumption of moderate amounts of polyphenol-rich dark chocolate approximately 30 calories a day may help reduce above optimal blood pressure (BP) without affecting body weight, according to a new study in JAMA (2007;298(1):49-60). Researchers from University Hospital of Cologne enrolled 44 adults aged 56 to 73 years old with untreated upper-range prehypertension or stage 1 hypertension without concomitant risk factors in the randomized, controlled, parallel group trial. For 18 weeks, participants received either 6.3 g/d of dark chocolate with 30 mg of polyphenols or matching polyphenol-free white chocolate. The primary outcome measure was change in BP, with secondary outcomes of changes in plasma markers of vasodilative nitric oxide (NO) and oxidative stress, plus bioavailability of cocoa polyphenols. From baseline to 18 weeks, dark chocolate intake reduced mean systolic BP by -2.9 (1.6) mm Hg, and diastolic BP by -1.9 (1.0) mm Hg, without changes in body weight, plasma levels of lipids, glucose or oxidative stress. Hypertension prevalence declined from 86 percent to 68 percent. The decrease in blood pressure was accompanied by an increase in markers of NO and the appearance of cocoa phenols in plasma. White chocolate intake had no effect on BP, NO or oxidative stress markers.

"Although the magnitude of the BP reduction was small, the effects are clinically noteworthy. On a population basis, it has been estimated that a 3-mm Hg reduction in systolic BP would reduce the relative risk of stroke mortality by 8 percent, of coronary artery disease mortality by 5 percent, and of all-cause mortality by 4 percent," the authors wrote. "The most intriguing finding of this study is that small amounts of commercial cocoa confectionary convey a similar BP-lowering potential compared with comprehensive dietary modifications that have proven efficacy to reduce cardiovascular event rate. Whereas long-term adherence to complex behavioral changes is often low and requires continuous counseling, adoption of small amounts of flavanol-rich cocoa into the habitual diet is a dietary modification that is easy to adhere to and therefore may be a promising behavioral approach to lower blood pressure in individuals with above-optimal blood pressure."

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