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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Chocolate and cocoa: at last some good news for chocolate addicts

Vanessa Jordan
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Correspondence to: Vanessa Jordan, New Zealand Cochrane Fellow, University of Auckland, Auckland, New Zealand. Email: v.jordan@auckland.ac.nz

Journal of Primary Health Care 9(2) 181-181 https://doi.org/10.1071/HC15923
Published: 30 June 2017

Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Cochrane Review: Ried K, Fakler P, Stocks NP. Effect of cocoa on blood pressure. Cochrane Database of Systematic Reviews 2017, Issue 4.

The Problem: Hypertension is a known public health problem that affects both the economic developed and developing world and effects somewhere between 25–33% of the adult population.1 It is one of the leading factors attributing to global mortality and is the third highest risk factor for the global burden of disease.2 This research examined the use of cocoa as a potential antihypertensive. It is the flavanols contained within the cocoa that is thought to be responsible for antihypertensive action.3

Clinical Bottom Line: This Cochrane review showed that cocoa delivered either as a commercially available chocolate or as cocoa powder, will reduce systolic and diastolic blood pressure.4 The antihypertensive effect appeared to be strongest among individuals with pre-existing hypertension where the addition of cocoa to the diet reduced systolic blood pressure by 4 mmHg (6.71–1.30).

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Outcome measured Success Evidence Harms
Systolic blood pressure Overall the mean systolic blood pressure in the groups that received cocoa was 1.76 mm Hg (CI = 3.09 to 0.43) lower than those in the control group.
If trials only included hypertensive patients, the systolic blood pressures were lowered by 4 mm Hg (6.71–1.30).
If trials only included normotensive patients, the systolic blood pressure was not significantly lowered.
This was based on 35 trials including 1804 participants.
9 trials including 401 participants looked at hypertensive patients 20 trials including 1063 participants looked at normotensive patients.
9 trials reported participants that had withdrawn due to adverse events.
These included gastrointestinal complaints, dislike of the trial product, headache and jitteriness.
Diastolic blood pressure The mean diastolic blood pressure in the group that received cocoa was 1.76 mm Hg (CI = 2.57 to 0.94) lower than those in the control group. This was based on evidence from 34 trials including 1772 participants.





References

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[2]  Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360 1347–60.
Selected major risk factors and global and regional burden of disease.Crossref | GoogleScholarGoogle Scholar |

[3]  Corti R, Flammer AJ, Hollenberg NK, Lüscher TF. Cocoa and cardiovascular health. Circulation 2009; 119 1433–41.
Cocoa and cardiovascular health.Crossref | GoogleScholarGoogle Scholar |

[4]  Ried K, Fakler P, Stocks NP. Effect of cocoa on blood pressure. Cochrane Database of Systematic Reviews 2017;
Effect of cocoa on blood pressure.Crossref | GoogleScholarGoogle Scholar |