Effect of Cocoa Products on Blood Pressure:
Systematic Review and Meta-analysis

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   American Journal of Hypertension 2010 (Jan);   23 (1):   97–103

Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I,
Sareban M, Rahimi K, Schuler G, Thiele H.

Department of Cardiology,
University of Leipzig-Heart Center,
Leipzig, Germany.
stdesch@web.de

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The evidence supporting the antihypertensive effects of cocoa has been building over the last few years, and this systematic review and meta-analysis of 10 randomized controlled trials, comprising 297 individuals confirms the BP-lowering capacity of flavanol-rich cocoa products. The high level of flavanols found in the cocoa plant is believed to be responsible for the lowering of blood pressure.

BACKGROUND:   Cocoa products such as dark chocolate and cocoa beverages may have blood pressure (BP)-lowering properties due to their high content of plant-derived flavanols.

METHODS:   We performed a meta-analysis of randomized controlled trials assessing the antihypertensive effects of flavanol-rich cocoa products. The primary outcome measure was the change in systolic and diastolic BP between intervention and control groups.

RESULTS:   In total, 10 randomized controlled trials comprising 297 individuals were included in the analysis. The populations studied were either healthy normotensive adults or patients with prehypertension/stage 1 hypertension. Treatment duration ranged from 2 to 18 weeks. The mean BP change in the active treatment arms across all trials was -4.5 mm Hg (95% confidence interval (CI), -5.9 to -3.2, P < 0.001) for systolic BP and -2.5 mm Hg (95% CI, -3.9 to -1.2, P < 0.001) for diastolic BP.

CONCLUSIONS:   The meta-analysis confirms the BP-lowering capacity of flavanol-rich cocoa products in a larger set of trials than previously reported. However, significant statistical heterogeneity across studies could be found, and questions such as the most appropriate dose and the long-term side effect profile warrant further investigation before cocoa products can be recommended as a treatment option in hypertension.

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