Effects on peripheral and central blood pressure of cocoa with natural or high-dose theobromine: A randomized, double-blind crossover trial

Hypertension

Volumn 56, Issue 5, 2010, Pages 839-846

  Van Den Bogaard, Bas ^a   Draijer, Richard ^b   Westerhof, Berend E ^c   Van Den Meiracker, Anton H ^d   Van Montfrans, Gert A ^a   Van Den Born, Bert Jan H ^a  

^a UNIVERSITY OF AMSTERDAM   (Netherlands)

^b UNILEVER RESEARCH VLAARDINGEN   (Netherlands)

^c BMEYE BV   (Netherlands)

^d ERASMUS MEDICAL CENTER   (Netherlands)

Author keywords

aortic pressure waveform; blood pressure; cocoa; hemodynamics; theobromine

Indexed keywords

PLACEBO; THEOBROMINE;

ADULT; ARTICLE; BLOOD PRESSURE MONITORING; CACAO; CARDIOVASCULAR RISK; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY HEMODYNAMICS; CROSSOVER PROCEDURE; DAIRY PRODUCT; DOUBLE BLIND PROCEDURE; DRUG EFFECT; DRUG MEGADOSE; DRUG WITHDRAWAL; FEMALE; FLUID INTAKE; HEADACHE; HUMAN; HYPERTENSION; LABORATORY TEST; MALE; NAUSEA; NORMAL HUMAN; PERIPHERAL CIRCULATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SYSTEMIC CIRCULATION; SYSTOLIC BLOOD PRESSURE; TREATMENT DURATION; AGED; BEVERAGE; BLOOD PRESSURE; MIDDLE AGED; TREATMENT OUTCOME;

AGED; BEVERAGES; BLOOD PRESSURE; CACAO; CROSS-OVER STUDIES; DOUBLE-BLIND METHOD; FEMALE; HUMANS; MALE; MIDDLE AGED; THEOBROMINE; TREATMENT OUTCOME;

EID: 78149271720     PISSN: 0194911X     EISSN: None     Source Type: Journal    
DOI: 10.1161/HYPERTENSIONAHA.110.158139     Document Type: Article

References (37)

1. Hertog MG, Feskens EJ, Hollman PC, Katan MB, Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet. 1993;342:1007-1011.
2. Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study. Arch Intern Med. 2006;166:411-417.
3. Buijsse B, Weikert C, Drogan D, Bergmann M, Boeing H. Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults. Eur Heart J. 2010;31:1616-1623.
4. Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I, Sareban M, Rahimi K, Schuler G, Thiele H. Effect of cocoa products on blood pressure: systematic review and meta-analysis. Am J Hypertens. 2010;23:97-103.
5. Crews WD Jr, Harrison DW, Wright JW. A double-blind, placebocontrolled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults. Am J Clin Nutr. 2008;87:872-880.
6. Muniyappa R, Hall G, Kolodziej TL, Karne RJ, Crandon SK, Quon MJ. Cocoa consumption for 2 wk enhances insulin-mediated vasodilatation without improving blood pressure or insulin resistance in essential hypertension. Am J Clin Nutr. 2008;88:1685-1696.
7. Murphy KJ, Chronopoulos AK, Singh I, Francis MA, Moriarty H, Pike MJ, Turner AH, Mann NJ, Sinclair AJ. Dietary flavanols and procyanidin oligomers from cocoa (Theobroma cacao) inhibit platelet function. Am J Clin Nutr. 2003;77:1466-1473.
8. Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, Umans JG, Howard BV. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007;50:197-203.
9. Vlachopoulos CV, Alexopoulos NA, Aznaouridis KA, Ioakeimidis NC, Dima IA, Dagre A, Vasiliadou C, Stefanadi EC, Stefanadis CI. Relation of habitual cocoa consumption to aortic stiffness and wave reflections, and to central hemodynamics in healthy individuals. Am J Cardiol. 2007;99:1473-1475.
10. Fisher ND, Hughes M, Gerhard-Herman M, Hollenberg NK. Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans. J Hypertens. 2003;21:2281-2286.
11. Actis-Goretta L, Ottaviani JI, Fraga CG. Inhibition of angiotensin converting enzyme activity by flavanol-rich foods. J Agric Food Chem. 2006;54:229-234.
12. Schewe T, Steffen Y, Sies H. How do dietary flavanols improve vascular function? A position paper. Arch Biochem Biophys. 2008;476:102-106.
13. Ramirez-Sanchez I, Maya L, Ceballos G, Villarreal F. (-)-Epicatechin activation of endothelial cell endothelial nitric oxide synthase, nitric oxide, and related signaling pathways. Hypertension. 2010;55:1398-1405.
14. Cooper KA, Campos-Gimenez E, Jimenez AD, Rytz A, Nagy K, Williamson G. Predictive relationship between polyphenol and nonfat cocoa solids content of chocolate. J Agric Food Chem. 2008;56:260-265.
15. Kelly CJ. Effects of theobromine should be considered in future studies. Am J Clin Nutr. 2005;82:486-487.
16. Kamphuis J, Smits P, Thien T. Vascular effects of pentoxifylline in humans. J Cardiovasc Pharmacol. 1994;24:648-654.
17. Pauca AL, O'Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension. 2001;38:932-937.
18. Eeftinck Schattenkerk DW, van Lieshout JJ, van den Meiracker AH, Wesseling KR, Blanc S, Wieling W, van Montfrans GA, Settels JJ, Wesseling KH, Westerhof BE. Nexfin noninvasive continuous blood pressure validated against Riva-Rocci/Korotkoff. Am J Hypertens. 2009;22:378-383.
19. Guelen I, Westerhof BE, van der Sar GL, van Montfrans GA, Kiemeneij F, Wesseling KH, Bos WJ. Validation of brachial artery pressure reconstruction from finger arterial pressure. J Hypertens. 2008;26:1321-1327.
20. Campbell DJ, Nussberger J, Stowasser M, Danser AH, Morganti A, Frandsen E, Menard J. Activity assays and immunoassays for plasma Renin and prorenin: information provided and precautions necessary for accurate measurement. Clin Chem. 2009;55:867-877.
21. Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995;155:701-709.
22. Beltman FW, Heesen WF, Kok RH, Smit AJ, May JF, de Graeff PA, Havinga TK, Schuurman FH, van d, V, Lie KI, Meyboom-de JB. Predictive value of ambulatory blood pressure shortly after withdrawal of antihypertensive drugs in primary care patients. BMJ. 1996;313:404-406.
23. Egan BM, Laken MA, Donovan JL, Woolson RF. Does dark chocolate have a role in the prevention and management of hypertension?: commentary on the evidence. Hypertension. 2010;55:1289-1295.
24. Heiss C, Jahn S, Taylor M, Real WM, Angeli FS, Wong ML, Amabile N, Prasad M, Rassaf T, Ottaviani JI, Mihardja S, Keen CL, Springer ML, Boyle A, Grossman W, Glantz SA, Schroeter H, Yeghiazarians Y. Improvement of endothelial function with dietary flavanols is associated with mobilization of circulating angiogenic cells in patients with coronary artery disease. J Am Coll Cardiol. 2010;56:218-224.
25. Karim M, McCormick K, Kappagoda CT. Effects of cocoa extracts on endothelium-dependent relaxation. J Nutr. 2000;130:2105S-2108S.
26. Usmani OS, Belvisi MG, Patel HJ, Crispino N, Birrell MA, Korbonits M, Korbonits D, Barnes PJ. Theobromine inhibits sensory nerve activation and cough. FASEB J. 2005;19:231-233.
27. Carney JM, Wu C, Logan L, Rennert OM, Seale TW. Differential antagonism of the behavioral depressant and hypothermic effects of 5'-(N-ethylcarboxamide) adenosine by theobromine. Pharmacol Biochem Behav. 1986;25:769-773.
28. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ. The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol. 2000;525:263-270.
29. Williams B, Lacy PS. Impact of heart rate on central aortic pressures and hemodynamics: analysis from the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate. J Am Coll Cardiol. 2009;54:705-713.
30. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thurston H, O'Rourke M. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) Study. Circulation. 2006;113:1213-1225.
31. Smulyan H, Mukherjee R, Sheehe PR, Safar ME. Cuff and aortic pressure differences during dobutamine infusion: a study of the effects of systolic blood pressure amplification. Am Heart J. 2010;159:399-405.
32. Fornai M, Antonioli L, Colucci R, Ghisu N, Buccianti P, Marioni A, Chiarugi M, Tuccori M, Blandizzi C, Del TM. A1 and A2a receptors mediate inhibitory effects of adenosine on the motor activity of human colon. Neurogastroenterol Motil. 2009;21:451-466.
33. Roura E, Andres-Lacueva C, Estruch R, Mata-Bilbao ML, Izquierdo-Pulido M, Waterhouse AL, Lamuela-Raventos RM. Milk does not affect the bioavailability of cocoa powder flavonoid in healthy human. Ann Nutr Metab. 2007;51:493-498.
34. Schroeter H, Heiss C, Balzer J, Kleinbongard P, Keen CL, Hollenberg NK, Sies H, Kwik-Uribe C, Schmitz HH, Kelm M. (-)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proc Natl Acad Sci U S A. 2006;103:1024-1029.
35. Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr. 2005;81:611-614.
36. Grassi D, Necozione S, Lippi C, Croce G, Valeri L, Pasqualetti P, Desideri G, Blumberg JB, Ferri C. Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives. Hypertension. 2005;46:398-405.
37. Taubert D, Roesen R, Lehmann C, Jung N, Schomig E. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA. 2007;298:49-60.