Dark Chocolate and Blood Pressure Reductions

Diet and exercise are the general non-medicinal recommendations to reduce blood pressure. This makes some sense, in general, for overall health improvements. A German study has concluded that low amounts of daily consumption of dark chocolate can have a marginal but still significant outcome in reducing blood pressure.

Dr. Dirk Taubert, of the University Hospital of Cologne, published his findings in JAMA.

Here’s the recipe: Eat 6.3g of dark chocolate (min 70% cocoa) daily, 2 hrs after your last meal, and within 18 weeks reductions of 3mm hg systolic and 2mm hg
diastolic blood pressure can be observed.

At least there was little complaining about the experiment. Who would complain about doctor prescribed chocolate? The study was small, involving only 44 adults from the ages of 56 to 73. 24 women and 20 men.

Results From baseline to 18 weeks, dark chocolate intake reduced mean (SD) systolic BP by −2.9 (1.6) mm Hg (P < .001) and diastolic BP by −1.9 (1.0) mm Hg (P < .001) without changes in body weight, plasma levels of lipids, glucose, and 8-isoprostane. Hypertension prevalence declined from 86% to 68%. The BP decrease was accompanied by a sustained increase of S-nitrosoglutathione by 0.23 (0.12) nmol/L (P < .001), and a dark chocolate dose resulted in the appearance of cocoa phenols in plasma. White chocolate intake caused no changes in BP or plasma biomarkers. Conclusions Data in this relatively small sample of otherwise healthy individuals with above-optimal BP indicate that inclusion of small amounts of polyphenol-rich dark chocolate as part of a usual diet efficiently reduced BP and improved formation of vasodilative nitric oxide.

Although the magnitude of the BP reduction was small, the effects are clinically noteworthy. On a population basis, it has been estimated that a 3-mm Hg reduction in systolic BP would reduce the relative risk of stroke mortality by 8%, of coronary artery disease mortality by 5%, and of all-cause mortality by 4%.1 Furthermore, the blood pressure reductions in our randomized trial are in the same range that were reportedly associated with habitual cocoa intake (a median of 4.2 g per day) in an epidemiological study involving elderly men.32 However, the high degree of relative risk reduction of about 50% in cardiovascular or all-cause mortality in that study suggests that cocoa or other dietary components may be associated with additional cardioprotective effects beyond BP decrease…

The most intriguing finding of this study is that small amounts of commercial cocoa confectionary convey a similar BP-lowering potential compared with comprehensive dietary modifications46,47 that have proven efficacy to reduce cardiovascular event rate.48,49 Whereas long-term adherence to complex behavioral changes is often low and requires continuous counseling,50 adoption of small amounts of flavanol-rich cocoa into the habitual diet is a dietary modification that is easy to adhere to and therefore may be a promising behavioral approach to lower blood pressure in individuals with above-optimal blood pressure. Future studies should evaluate the effects of dark chocolate in other populations and evaluate long-term outcomes.

What I am reading is that eating small amounts of cocoa chocolate has a similar efficacy as proven dietary restrictions.

NHS.uk

Benefits and Harms of Antihypertensive Treatment in Low-Risk Patients With Mild Hypertension: study shows that those with moderate hypertension, BP drugs have no significant benefit and come with side effects

Conclusions and Relevance

This prespecified analysis found no evidence to support guideline recommendations that encourage initiation of treatment in patients with low-risk mild hypertension. There was evidence of an increased risk of adverse events, which suggests that physicians should exercise caution when following guidelines that generalize findings from trials conducted in high-risk individuals to those at lower risk.