Cacao or Cocoa is extracted from cocoa beans, the fatty seeds found on the Theobroma cacao tree. Rich in flavanols, cocoa is believed to have blood pressure lowering effects.
About 116 million Americans have high blood pressure, many of whom do not have it under control. New research shows that cocoa consumption lowers blood pressure in healthy adults, providing implications for future treatments for hypertension. While the results look promising, eating more chocolate products is not a recommended strategy to help lower blood pressure. Instead, heart-healthy diets, such as the DASH diet and the Mediterranean diet, are recommended for people with high blood pressure.
People living with high blood pressure (hypertension) face an increased risk of heart disease and stroke, two of the leading causes of death in the United States. According to the U.S. Centers for Disease Control and Prevention (CDC), 116 million American adults — nearly half of all adults — have high blood pressure, and many do not have it under control.
Dr Michael Goyfman, chief of cardiology and director of echocardiography at Long Island Jewish Forest Hills Hospital in Queens, New York, says: “High blood pressure affects nearly every organ in the body. "If left unchecked, it can lead to stroke, heart attack and kidney damage, among other complications."
Heart-healthy diets are often recommended for people with high blood pressure.
Now, a new study published in the journal Frontiers in Nutrition shows that consuming flavanol-rich cocoa can help lower blood pressure and reduce arterial stiffness, offering exciting implications for future treatments.
The flavanols in cocoa and blood pressure
Flavanol - a subgroup of flavonoids - is a plant-based compound found in common foods and beverages such as tea, blueberries, red wine, and cocoa.
Cocoa is extracted from cocoa beans, the fatty seeds found on the Theobroma cacao tree. Rich in flavanols, cocoa is believed to have blood pressure lowering effects.
In fact, previous studies have shown that flavanol-rich cocoa and chocolate products cause short-term reductions in blood pressure in healthy adults. However, the long-term effects are still not fully understood.
For the new study, researchers at the University of Surrey set out to explore whether cocoa flavanols lower blood pressure in healthy adults without lowering blood pressure on controlled days.
Over several days, the researchers gave 11 participants either six cocoa flavanol capsules (about 860 milligrams) or six placebo capsules containing brown sugar, on alternating days.
Participants were also provided with a biceps sphygmomanometer and a pulse wave velocity (PWV) finger clip to measure arterial stiffness.
Christian Heiss, professor of Cardiovascular Medicine at the University of Surrey, said: "High blood pressure and arterial stiffness increase a person's risk of heart disease and stroke, so it's important that we research innovative approaches to treating those conditions."
No effect when blood pressure is low
The participants' blood pressure and PWV were measured before consuming cocoa capsules and every 30 minutes for the first three hours, then every hour for the next 9 hours.
The results of the study noted that systolic blood pressure was reduced by about 1.4 mmHg in 12 hours.
The effects were also detected eight hours after cocoa was consumed, a "second peak" that the researchers believe may be due to the way gut bacteria metabolize flavanols.
The researchers also noted that blood pressure and arterial stiffness decreased in the participants only if it was high and had no effect when blood pressure was low in the morning.
Can cocoa treat high blood pressure?
According to a press release, the new study "reduces concerns that cocoa as a treatment for elevated blood pressure may pose health risks by lowering blood pressure when it is not raised".
This means that cocoa can be used in clinical practice.
However, Dr. Mehrdad Rezaee, a cardiologist at O'Connor Hospital in San Jose, California who was not involved in the study, noted that the new study has some limitations.
“Researchers have not tested this substance for a long time and in a clinically relevant situation,” says Rezaee. "So for now this is still a hypothesis that has been resolved in a very controlled environment."
Recommendations for a heart-healthy diet
Experts expressed concern that people living with hypertension, diabetes and obesity would take the study as a recommendation to consume chocolate products that tend to be high in sugar and fat.
“Currently, I always recommend the DASH and Mediterranean diets to my high blood pressure patients.”
Key point
New research shows that cocoa flavanols can safely lower blood pressure in healthy people, but more rigorous studies are still needed to determine whether cocoa products can help treat hypertension.
Although some experts say the findings could pave the way for new treatments, because the study was small, the results aren't clinically meaningful.
Eating a lot of chocolate, which contains a lot of sugar and fat, is not recommended for people with high blood pressure and other chronic diseases.
Instead, experts recommend heart-healthy diets like DASH and the Mediterranean diet to help lower high blood pressure.
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