Cocoa, Blood Pressure, and Cardiovascular Health

Journal of Agricultural and Food Chemistry

Volumn 63, Issue 45, 2015, Pages 9901-9909

  Ferri, Claudio ^a   Desideri, Giovambattista ^a   Ferri, Livia ^a   Proietti, Ilenia ^a   Di Agostino, Stefania ^a   Martella, Letizia ^a   Mai, Francesca ^a   Di Giosia, Paolo ^a   Grassi, Davide ^a  

^a UNIVERSITY OF L'AQUILA   (Italy)

Author keywords

blood pressure; cardiovascular health; cocoa; endothelium; polyphenols

Indexed keywords

AMINO ACIDS; BLOOD PRESSURE; CARDIOLOGY; DISEASES; FLAVONOIDS; HEALTH; NITRIC OXIDE; RISK PERCEPTION;

CARDIO-VASCULAR DISEASE; CARDIOVASCULAR EVENT; ENDOTHELIUM; EPIDEMIOLOGICAL STUDIES; NITRIC-OXIDE SYNTHASE; PLATELET AGGREGATION; POLYPHENOLS; SYSTOLIC BLOOD PRESSURE;

COCOA;

PLANT EXTRACT;

ANIMAL; BLOOD PRESSURE; CACAO; CARDIOVASCULAR DISEASE; CARDIOVASCULAR SYSTEM; DIET THERAPY; HUMAN; METABOLISM; PATHOPHYSIOLOGY;

ANIMALS; BLOOD PRESSURE; CACAO; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; HUMANS; PLANT EXTRACTS;

EID: 84947766476     PISSN: 00218561     EISSN: 15205118     Source Type: Journal    
DOI: 10.1021/acs.jafc.5b01064     Document Type: Article

References (66)

1. Lawes, C. M.; Vander Hoorn, S.; Law, M. R. et al. Blood pressure and the global burden of disease. Part II. Estimates of attributable burden J. Hypertens. 2006, 24, 423-430 10.1097/01.hjh.0000209973.67746.f0
2. Mancia, G.; Fagard, R.; Narkiewicz, K.; Redón, J.; Zanchetti, A.; Böhm, M.; Christiaens, T.; Cifkova, R.; De Backer, G.; Dominiczak, A.; Galderisi, M.; Grobbee, D. E.; Jaarsma, T.; Kirchhof, P.; Kjeldsen, S. E.; Laurent, S.; Manolis, A. J.; Nilsson, P. M.; Ruilope, L. M.; Schmieder, R. E.; Sirnes, P. A.; Sleight, P.; Viigimaa, M.; Waeber, B.; Zannad, F. Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) J. Hypertens. 2013, 31 (7) 1281-1357 10.1097/01.hjh.0000431740.32696.cc
3. Grassi, D.; Desideri, G.; Ferri, C. Cardiovascular risk and endothelial dysfunction: the preferential route for atherosclerosis Curr. Pharm. Biotechnol. 2011, 12 (9) 1343-1353 10.2174/138920111798281018
4. Wang, X.; Ouyang, Y.; Liu, J.; Zhu, M.; Zhao, G.; Bao, W.; Hu, F. B. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies BMJ. 2014, 349, g4490 10.1136/bmj.g4490
5. Trichopoulou, A.; Costacou, T.; Bamia, C.; Trichopoulos, D. Adherence to a Mediterranean diet and survival in a Greek population N. Engl. J. Med. 2003, 348, 2599-2608 10.1056/NEJMoa025039
6. Grassi, D.; Desideri, G.; Di Giosia, P.; De Feo, M.; Fellini, E.; Cheli, P.; Ferri, L.; Ferri, C. Tea, flavonoids, and cardiovascular health: endothelial protection Am. J. Clin. Nutr. 2013, 98 (6 Suppl.) 1660S-1666S 10.3945/ajcn.113.058313
7. Grassi, D.; Desideri, G.; Ferri, C. Protective effects of dark chocolate on endothelial function and diabetes Curr. Opin. Clin. Nutr. Metab. Care 2013, 16 (6) 662-668 10.1097/MCO.0b013e3283659a51
8. Grassi, D.; Desideri, G.; Ferri, C. Flavonoids: antioxidants against atherosclerosis Nutrients 2010, 2 (8) 889-902 10.3390/nu2080889
9. Grassi, D.; Desideri, G.; Croce, G.; Tiberti, S.; Aggio, A.; Ferri, C. Flavonoids, vascular function and cardiovascular protection Curr. Pharm. Des. 2009, 15 (10) 1072-1084 10.2174/138161209787846982
10. Scalbert, A.; Manach, C.; Morand, C. et al. Dietary polyphenols and the prevention of diseases Crit. Rev. Food Sci. Nutr. 2005, 45, 287-306 10.1080/1040869059096
11. Lazarus, S. A.; Adamson, G. E.; Hammerstone, J. F. et al. High-performance liquid Chromatography/Mass spectrometry analysis of proanthocyanidins in foods and beverages J. Agric. Food Chem. 1999, 47, 3693-3701 10.1021/jf9813642
12. Hollenberg, N.; Martinez, G.; McCullough, M. et al. Aging, acculturation, salt intake, and hypertension in the Kuna of Panama Hypertension 1997, 29, 171-176 10.1161/01.HYP.29.1.171
13. Buijsse, B.; Feskens, E. J.; Kok, F. J. et al. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study Arch. Intern. Med. 2006, 166, 411-417 10.1001/archinte.166.4.411
14. Buijsse, B.; Weikert, C.; Drogan, D. et al. Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults Eur. Heart J. 2010, 31 (13) 1616-1623 10.1093/eurheartj/ehq068
15. Cassidy, A.; O'Reilly, é. J.; Kay, C. et al. Habitual intake of flavonoid subclasses and incident hypertension in adults Am. J. Clin. Nutr. 2011, 93 (2) 338-347 10.3945/ajcn.110.006783
16. Alonso, A.; de la Fuente, C.; Beunza, J. J. et al. Chocolate consumption and incidence of hypertension Hypertension 2005, 46, e21-e22 10.1161/01.HYP.0000190583.88379.69
17. Galleano, M.; Bernatova, I.; Puzserova, A.; Balis, P.; Sestakova, N.; Pechanova, O.; Fraga, C. G. (-)-Epicatechin reduces blood pressure and improves vasorelaxation in spontaneously hypertensive rats by NO-mediated mechanism IUBMB Life 2013, 65 (8) 710-715 10.1002/iub.1185
18. Litterio, M. C.; Jaggers, G.; Sagdicoglu Celep, G.; Adamo, A. M.; Costa, M. A.; Oteiza, P. I.; Fraga, C. G.; Galleano, M. Blood pressure-lowering effect of dietary (-)-epicatechin administration in L-NAME-treated rats is associated with restored nitric oxide levels Free Radical Biol. Med. 2012, 53 (10) 1894-1902 10.1016/j.freeradbiomed.2012.08.585
19. Cienfuegos-Jovellanos, E.; Quiñones Mdel, M.; Muguerza, B. et al. Antihypertensive effect of a polyphenol-rich cocoa powder industrially processed to preserve the original flavonoids of the cocoa beans J. Agric. Food Chem. 2009, 57, 6156-6162 10.1021/jf804045b
20. Sánchez, D.; Quiñones, M.; Moulay, L.; Muguerza, B.; Miguel, M.; Aleixandre, A. Changes in arterial blood pressure of a soluble cocoa fiber product in spontaneously hypertensive rats J. Agric. Food Chem. 2010, 58, 1493-1501 10.1021/jf902080b
21. Grassi, D.; Desideri, G.; Ferri, C. Blood pressure and cardiovascular risk: what about cocoa and chocolate? Arch. Biochem. Biophys. 2010, 501 (1) 112-115 10.1016/j.abb.2010.05.020
22. Grassi, D.; Lippi, C.; Necozione, S. et al. 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 (3) 611-614
23. Grassi, D.; Necozione, S.; Lippi, C. et al. Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives Hypertension 2005, 46 (2) 398-405 10.1161/01.HYP.0000174990.46027.70
24. Grassi, D.; Desideri, G.; Necozione, S. et al. Blood pressure is reduced and insulin sensitivity increased in glucose-intolerant, hypertensive subjects after 15 days of consuming high-polyphenol dark chocolate J. Nutr. 2008, 138 (9) 1671-1676
25. Taubert, D.; Roesen, R.; Lehmann, C. et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial JAMA 2007, 298, 49-60 10.1001/jama.298.1.49
26. Faridi, Z.; Njike, V. Y.; Dutta, S. et al. Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial Am. J. Clin. Nutr. 2008, 88, 58-63
27. Saftlas, A. F.; Triche, E. W.; Beydoun, H. et al. Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension? Ann. Epidemiol. 2010, 20 (8) 584-591 10.1016/j.annepidem.2010.05.010
28. Davison, K.; Berry, N. M.; Misan, G. et al. Dose-related effects of flavanol-rich cocoa on blood pressure J. Hum. Hypertens. 2010, 24 (9) 568-576 10.1038/jhh.2009.105
29. Berry, N. M.; Davison, K.; Coates, A. M. et al. Impact of cocoa flavanol consumption on blood pressure responsiveness to exercise Br. J. Nutr. 2010, 19, 1-5 10.1017/S0007114509993382
30. Grassi, D.; Desideri, G.; Necozione, S.; Di Giosia, P.; Barnabei, R.; Allegaert, L.; Bernaert, H.; Ferri, C. Cocoa consumption dose-dependently improves flow-mediated dilation and arterial stiffness decreasing blood pressure in healthy individuals J. Hypertens. 2015, 33 (2) 294-303 10.1097/HJH.0000000000000412
31. Shrime, M. G.; Bauer, S. R.; McDonald, A. C.; Chowdhury, N. H.; Coltart, C. E.; Ding, E. L. Flavonoid-rich cocoa consumption affects multiple cardiovascular risk factors in a meta-analysis of short-term studies J. Nutr. 2011, 141, 1982-1988 10.3945/jn.111.145482
32. Hooper, L.; Kroon, P. A.; Rimm, E. B.; Cohn, J. S.; Harvey, I.; Le Cornu, K. A. et al. Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials Am. J. Clin. Nutr. 2008, 88, 38-50
33. Hooper, L.; Kay, C.; Abdelhamid, A.; Kroon, P. A.; Cohn, J. S.; Rimm, E. B.; Cassidy, A. Effects of chocolate, cocoa, and flavan-3-ols on cardiovascular health: a systematic review and meta-analysis of randomized trials Am. J. Clin. Nutr. 2012, 95, 740-751 10.3945/ajcn.111.023457
34. Ried, K.; Sullivan, T.; Fakler, P. et al. Does chocolate reduce blood pressure? A meta-analysis BMC Med. 2010, 8, 39 10.1186/1741-7015-8-39
35. Glynn, R. J.; L'Italien, G. J.; Sesso, H. D. et al. Development of predictive models for long-term cardiovascular risk associated with systolic and diastolic blood pressure Hypertension 2002, 39, 105-110 10.1161/hy1201.097199
36. Egan, B. M.; Laken, M. A.; Donovan, J. L. et al. Does dark chocolate have a role in the prevention and management of hypertension?: commentary on the evidence Hypertension 2010, 55 (6) 1289-1295 10.1161/HYPERTENSIONAHA.110.151522
37. Ried, K.; Sullivan, T. R.; Fakler, P.; Frank, O. R.; Stocks, N. P. Effect of cocoa on blood pressure Cochrane Database Syst. Rev. 2012, 8, CD008893 10.1002/14651858.CD008893.pub2
38. Taubert, D.; Berkels, R.; Roesen, R.; Klaus, W. Chocolate and blood pressure in elderly individuals with isolated systolic hypertension JAMA, J. Am. Med. Assoc. 2003, 290 (8) 1029-1030 10.1001/jama.290.8.1029
39. Muniyappa, R.; Hall, G.; Kolodziej, T. L.; Karne, R. J.; Crandon, S. K.; Quon, M. J. 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 (6) 1685-1696 10.3945/ajcn.2008.26457
40. Heiss, C.; Jahn, S.; Taylor, M.; Real, W. M.; Angeli, F. S.; Wong, M. L.; Amabile, N.; Prasad, M.; Rassaf, T.; Ottaviani, J. I.; Mihardja, S.; Keen, C. L.; Springer, M. L.; Boyle, A.; Grossman, W.; Glantz, S. A.; 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 (3) 218-224 10.1016/j.jacc.2010.03.039
41. Murphy, K. J.; Chronopoulos, A. K.; Singh, I.; Francis, M. A.; Moriarty, H.; Pike, M. J.; Turner, A. H.; Mann, N. J.; Sinclair, A. J. Dietary flavanols and procyanidin oligomers from cocoa (Theobroma cacao) inhibit platelet function Am. J. Clin. Nutr. 2003, 77 (6) 1466-1473
42. Engler, M. B.; Engler, M. M.; Chen, C. Y.; Malloy, M. J.; Browne, A.; Chiu, E. Y.; Kwak, H. K.; Milbury, P.; Paul, S. M.; Blumberg, J.; Mietus-Snyder, M. L. Flavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations in healthy adults J. Am. Coll. Nutr. 2004, 23 (3) 197-204 10.1080/07315724.2004.10719361
43. Fraga, C. G.; Actis-Goretta, L.; Ottaviani, J. I.; Carrasquedo, F.; Lotito, S. B.; Lazarus, S.; Schmitz, H. H.; Keen, C. L. Regular consumption of a flavanol-rich chocolate can improve oxidant stress in young soccer players Clin. Dev. Immunol. 2005, 12 (1) 11-17 10.1080/10446670410001722159
44. Crews, W. D., Jr; Harrison, D. W.; Wright, J. W. A double-blind, placebo-controlled, 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 (4) 872-880
45. Davison, K.; Coates, A. M.; Buckley, J. D.; Howe, P. R. Effect of cocoa flavanols and exercise on cardiometabolic risk factors in overweight and obese subjects Int. J. Obes. 2008, 32 (8) 1289-1296 10.1038/ijo.2008.66
46. Al-Faris, N. A. Short-term consumption of a dark chocolate containing flavanols is followed by a significant decrease in normotensive population Pakistan J. Nutr. 2008, 7, 773-781 10.3923/pjn.2008.773.781
47. Shiina, Y.; Funabashi, N.; Lee, K.; Murayama, T.; Nakamura, K.; Wakatsuki, Y.; Daimon, M.; Komuro, I. Acute effect of oral flavonoid-rich dark chocolate intake on coronary circulation, as compared with non-flavonoid white chocolate, by transthoracic Doppler echocardiography in healthy adults Int. J. Cardiol. 2009, 131 (3) 424-429 10.1016/j.ijcard.2007.07.131
48. Monagas, M.; Khan, N.; Andres-Lacueva, C.; Casas, R.; Urpí-Sardà, M.; Llorach, R.; Lamuela-Raventós, R. M.; Estruch, R. Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease Am. J. Clin. Nutr. 2009, 90 (5) 1144-1150 10.3945/ajcn.2009.27716
49. Njike, V. Y.; Faridi, Z.; Shuval, K.; Dutta, S.; Kay, C. D.; West, S. G.; Kris-Etherton, P. M.; Katz, D. L. Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults Int. J. Cardiol. 2011, 149 (1) 83-8 10.1016/j.ijcard.2009.12.010
50. European Food Safety Authority (EFSA) Scientific Opinion on the substantiation of a health claim related to cocoa flavanols and maintenance of normal endothelium-dependent vasodilation pursuant to Article 13(5) of Regulation (EC) No. 1924/20061 EFSA J. 2012, 10, 2809
51. Actis-Goretta, L.; Ottaviani, J. I.; Fraga, C. G. Inhibition of angiotensin converting enzyme activity by flavanol-rich foods J. Agric. Food Chem. 2006, 54 (1) 229-234 10.1021/jf052263o
52. Persson, I. A.; Josefsson, M.; Persson, K. et al. Tea flavanols inhibit angiotensin-converting enzyme activity and increase nitric oxide production in human endothelial cells J. Pharm. Pharmacol. 2006, 58, 1139-1144 10.1211/jpp.58.8.0016
53. Persson, I. A.; Persson, K.; Hägg, S. et al. Effects of cocoa extract and dark chocolate on angiotensin-converting enzyme and nitric oxide in human endothelial cells and healthy volunteers - a nutrigenomics perspective J. Cardiovasc. Pharmacol. 2011, 57 (1) 44-50 10.1097/FJC.0b013e3181fe62e3
54. Schewe, T.; Steffen, Y.; Sies, H. How do dietary flavanols improve vascular function? A position paper Arch. Biochem. Biophys. 2008, 476, 102-106 10.1016/j.abb.2008.03.004
55. Whelton, P. K.; He, J.; Appel, L. J.; Cutler, J. A.; Havas, S.; Kotchen, T. A.; Roccella, E. J.; Stout, R.; Vallbona, C.; Winston, M. C.; Karimbakas, J. National High Blood Pressure Education Program Coordinating Committee. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program JAMA 2002, 288 (15) 1882-1888 10.1001/jama.288.15.1882
56. Rice-Evans, C. A.; Miller, N. J.; Paganga, G. Structure-antioxidant activity relationships of flavonoids and phenolic acids Free Radical Biol. Med. 1996, 20, 933-956 10.1016/0891-5849(95)02227-9
57. Spencer, J. P. E.; Schroeter, H.; Crossthwaithe, A. J.; Kuhnle, G.; Williams, R. J.; Rice-Evans, C. Contrasting influences of glucuronidation and O-methylation of epicatechin on hydrogen peroxide- induced cell death in neurons and fibroblasts Free Radical Biol. Med. 2001, 31, 1139-1146 10.1016/S0891-5849(01)00704-3
58. Williams, R. J.; Spencer, J. P.; Rice-Evans, C. Flavonoids: antioxidants or signalling molecules? Free Radical Biol. Med. 2004, 36 (7) 838-849 10.1016/j.freeradbiomed.2004.01.001
59. Abd El Mohsen, M. M.; Kuhnle, G.; Rechner, A. R.; Schroeter, H.; Rose, S.; Jenner, P.; Rice-Evans, C. Uptake and metabolism of epicatechin and its access to the brain after oral ingestion Free Radical Biol. Med. 2002, 33, 1693-1702 10.1016/S0891-5849(02)01137-1
60. Halliwell, B.; Zhao, K.; Whiteman, M. The gastrointestinal tract: a major site of antioxidant action? Free Radical Res. 2000, 33, 819-830 10.1080/10715760000301341
61. Schroeter, H.; Boyd, C.; Spencer, J. P. E.; Williams, R. J.; Cadenas, E.; Rice-Evans, C. MAPK signaling in neurodegeneration: influences of flavonoids and of nitric oxide Neurobiol. Aging 2002, 23, 861-880 10.1016/S0197-4580(02)00075-1
62. Schroeter, H.; Williams, R. J.; Matin, R.; Iversen, L.; Rice-Evans, C. Phenolic antioxidants attenuate neuronal cell death following uptake of oxidized low-density lipoprotein Free Radical Biol. Med. 2000, 29, 1222-1233 10.1016/S0891-5849(00)00415-9
63. Schini-Kerth, V. B.; Auger, C.; Kim, J. H.; Etienne-Selloum, N.; Chataigneau, T. Nutritional improvement of the endothelial control of vascular tone by polyphenols: role of NO and EDHF Pfluegers Arch. 2010, 459, 853-862 10.1007/s00424-010-0806-4
64. Grassi, D.; Desideri, G.; Ferri, C. When dumbness turns vantages into disadvantages. From healthy ingredients to "bad foods" AgroFood Ind. Hi-Technol. 2010, 21 (4) 8-11
65. Ortega, R. M. Importance of functional foods in the Mediterranean diet Public Health Nutr. 2006, 9 (8A) 1136-1140 10.1017/S1368980007668530
66. Lippi, D. Chocolate in history: food, medicine, medi-food Nutrients 2013, 5 (5) 1573-1584 10.3390/nu5051573