Epidemiological studies have suggested that the daily intake of flavonoids is associated with a decreased risk of developing cardiovascular disease. Our purpose was to evaluate the effect of the addition of dietary flavonoids (DF) to antihypertensive treatment (AHT), based on telmisartan (Tms) or captopril (Cpr), on blood pressure (BP), body mass index (BMI), waist/hip ratio, leptin, lipid profile and inflammation in hypertensive young patients. An open-label, randomized, controlled trial was performed among 79 patients aged 20-55 years with grade I or grade II systemic arterial hypertension. The subjects were assigned to one of four groups for AHT plus DF during 6 months: Cpr (n = 14), Cpr + DF (n = 19), Tms (n = 25) and Tms + DF (n = 21). DF consisted of dark chocolate, dehydrated red apple and green tea in an infusion to obtain a daily dose of 425.8 AE 13.9 mg epicatechin equivalents. The BP and anthropometric parameters were measured every 2 weeks. Lipid profile, leptin and hsCRP were determined by standard methods. The combination AHT-DF produced an additional and significant reduction in (i) SBP/DBP of À5/À4 mmHg, being À7/À5 for Cpr + DF and À4/À3 for Tms + DF; (ii) triglyceride levels (À30.6%) versus AHT alone (À9.6%); and (iii) leptin: Cpr + DF versus Tms + DF (p < 0.005). Finally, C-reactive protein plasma levels were reduced significantly in all groups independently of the applied treatment. We conclude that the addition of flavonoids to pharmacological antihypertensive therapy shows additional benefits on BP, lipid profile, leptin, obesity and inflammation.High blood pressure is an important public health issue worldwide. It has been considered a major and independent factor that could lead to coronary heart disease, stroke and peripheral artery disease associated with metabolic alterations [1,2]. The therapeutic approach for hypertension (HT) is lifestyle modification and pharmacotherapy. Angiotensin converting enzyme (ACE) inhibitors (captopril, enalapril and ramipril), as antihypertensive therapy (AHT), are not considered able to correct the concomitant metabolic condition. Telmisartan, an angiotensin receptor blocker (ARB), has demonstrated pleiotropic effects on carbohydrate and lipid profiles, as well as on inflammatory processes [3]. Flavan-3-ols are aromatic compounds with a 2-phenyl-3,4-dihydro-2H-chromen-3-ol chemical skeleton (catechin) that are found as principal components in vegetables and other herbals such as green tea, red apple and cacao beans. These organic compounds have demonstrated beneficial effects on blood pressure (BP), inflammation, obesity and dyslipidaemia [4][5][6]. The Kuna people (Panama) that consume high quantities of cacao on a daily basis have shown a significant low mortality rate (9.2 AE 3.1 versus 83.4 AE 0.7 deaths/age/100,000) caused by cardiovascular diseases in comparison with other Pan American inhabitants [7]. In recent years, the anti-inflammatory and anticarcinogenic properties of flavan-3-ols, which are different from antioxidants, have been s...

The location where the vessels come in contact with the muscle, which can be considered for fat injection, were located in quadrants 1 and 3. A 30° angle allows for an injection into the muscle without passing into deeper structures, unlike a 45° injection angle.