Cocoa inhibits platelet activation and function

Rein, Dietrich; Paglieroni, Teresa; Wun, Ted; Pearson, Debra A.; Schmitz, Harold H.; Gosselin, Robert; Keen, Carl L.

doi:10.1093/ajcn/72.1.30

Cited by 315 publications

(199 citation statements)

References 44 publications

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“…This result is consistent with a potentially beneficial effect of black tea on platelet activation, rather than effects on endothelial cells. Our results are also supported by studies showing that polyphenols and a polyphenol-rich cocoa beverage suppress ex vivo stimulated and unstimulated markers of platelet activation (Rein et al, 2000a) and stimulated P-selectin expression (Rein et al, 2000b) in humans.…”

Section: Cell Adhesion Moleculesupporting

confidence: 85%

Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans

et al. 2001

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Objective: To assess the effects in humans of regular ingestion of black tea on haemostasis-related variables and cell adhesion molecules. Design: Twenty-two subjects were recruited from the general population to a randomised-controlled crossover study. Subjects stopped drinking tea, apart from that provided, for the duration of the study. During a 4-week baseline period all subjects drank 5 cups=day (250 ml) of hot water. The effects of 5 cups=day of black tea for 4 weeks were then compared with hot water. Platelet aggregation in response to three doses of collagen and ADP, plasma concentrations of coagulation and fibrinolytic factors (fibrinogen, factor VII, tPA, PAI-1) and plasma concentrations of cell adhesion molecules (soluble P-selectin, E-selectin, ICAM-1, VCAM-1) were assessed twice, one week apart, at the end of each period. Twenty-four hour urinary concentration of 4-O-methylgallic acid (4OMGA), assessed once at the end of each period, was used as a marker of black tea polyphenol intake. Results: The 24 h urinary excretion of 4OMGA was increased during regular ingestion of black tea in comparison to hot water (P<0.0001). Black tea resulted in lower soluble P-selectin (P ¼ 0.01) in comparison to hot water, but did not influence other adhesion molecules. Soluble P-selectin was significantly correlated with mean collagenstimulated platelet aggregation at baseline (r ¼ 0.61, P ¼ 0.003), and during regular ingestion of hot water (r ¼ 0.70, P<0.0001) and black tea (r ¼ 0.51, P ¼ 0.01). However, platelet aggregation was not different between the black tea and hot water periods for collagen-or ADP-stimulated aggregation at any dose. Coagulation and fibrinolytic factors were also not different between periods. Conclusions: The effect of black tea on soluble P-selectin provides a potential mechanism for cardiovascular benefits of regular ingestion of tea.

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Section: Cell Adhesion Moleculesupporting

confidence: 85%

Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans

et al. 2001

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“…35 Nevertheless, several recent reports have suggested that increased dietary flavonoid consumption may inhibit platelet activation and function in humans. 36,37 Rein and colleagues 36 randomized 30 healthy volunteers to either cocoa, a caffeine-containing control beverage, or water and found that cocoa consumption suppressed ADP-and epinephrine-stimulated platelet activation acutely and had an aspirinlike effect on primary hemostasis as measured with a platelet function analyzer. Cocoa is high in flavonoids, especially catechins, 38 and has been shown by Rein and colleagues to decrease plasma markers of oxidation.…”

Section: Discussionmentioning

confidence: 99%

“…The first study 36 assessed markers of platelet activation and function, and the second study 37 measured whole-blood aggregation. In the present study, we assessed ex vivo platelet aggregation in plateletrich plasma, a method that has been shown to relate to CAD mortality 40 and previous myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Effect of Acute and Chronic Tea Consumption on Platelet Aggregation in Patients With Coronary Artery Disease

Duffy

Vita

Holbrook

et al. 2001

ATVB

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Abstract-Epidemiological studies suggest that tea consumption is associated with a decreased risk of cardiovascular events, but the mechanisms of benefit remain undefined. Platelet aggregation is a precipitating event in cardiovascular disease, and tea contains antioxidant flavonoids that are known to decrease platelet aggregation in vitro. To test the effect of tea consumption on platelet aggregation, we randomized 49 patients with coronary artery disease to either 450 mL of black tea or water consumed initially, followed by 900 mL of tea or water daily for 4 weeks in a crossover design. Ex vivo platelet aggregation in platelet-rich plasma was assessed in response to ADP and thrombin receptor-activating peptide at baseline and 2 hours and 4 weeks after beverage consumption. We observed dose-dependent platelet aggregation in response to each agonist, and neither relation was altered by acute or chronic tea consumption. Plasma flavonoids increased with acute and chronic tea consumption, indicating adequate absorption of tea flavonoids. In conclusion, these results demonstrate that acute and chronic black tea consumption does not affect ex vivo platelet aggregation in patients with coronary artery disease. These findings suggest that an effect of tea flavonoids on platelet aggregation is unlikely to be the explanation for the reduction in risk of cardiovascular events noted in epidemiological studies. Key Words: platelet aggregation Ⅲ tea Ⅲ flavonoids Ⅲ coronary artery disease R ecent epidemiological studies strongly suggest an inverse relationship between tea consumption and cardiovascular disease risk, 1-5 with 1 notable exception. 6 There is also convincing evidence that dietary intake of antioxidant flavonoids from tea and other sources (eg, red wine, onions, apples, and broccoli) is associated with reduced cardiovascular risk. [1][2][3][4][5][7][8][9] The benefit of high flavonoid intake may be greater for individuals with established coronary artery disease (CAD), 1,10 although favorable effects have also been demonstrated in people without evidence of atherosclerosis. 5,8,9 One proposed mechanism for the apparent benefit of tea and other sources of flavonoids is their favorable effect on platelet aggregation. [11][12][13][14][15][16] These polyphenols may inhibit platelet aggregation by a number of different mechanisms, including inhibition of lipoxygenase, cyclooxygenase, 13,17 cAMP phosphodiesterase, 12,18 and cGMP phosphodiesterase. 19 Other platelet-inhibitory effects of flavonoids include thromboxane receptor antagonism, 15 scavenging of reactive oxygen species such as superoxide anion, 20 decreasing phospholipase C activation by blunting hydrogen peroxide production, 21 and inhibition of lipid peroxidation. 14 Flavonoids also enhance nitric oxide (NO) production from the endothelium. 22 NO is a potent inhibitor of platelet adhesion, aggregation, [23][24][25] and thrombosis, 26 and impaired platelet production of NO has been associated with acute coronary syndromes. 27 A recent study demonstrated dose-...

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“…The drink was prepared just before administration and ingested at room temperature, without applying any thermal treatment. Each drink contained 12 g of cocoa powder and 28 g of sugar according to other authors (6). MDA was prepared with 7 g of flavonoid-enriched powder plus 5 g of conventional cocoa powder while MDB was prepared with 12 g of conventional cocoa powder.…”

Section: Methodsmentioning

confidence: 99%

A New Process To Develop a Cocoa Powder with Higher Flavonoid Monomer Content and Enhanced Bioavailability in Healthy Humans

Tomás-Barberán

Cienfuegos-Jovellanos

Marín

et al. 2007

J. Agric. Food Chem.

212

158

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Cocoa is a food rich in polyphenols, mainly the flavonoid procyanidins and flavan-3-ols. The improvement of the cardiovascular function in humans upon cocoa consumption has been specifically linked to the presence of flavan-3-ol derived metabolites in plasma, especially epicatechin glucuronide. In this context, a flavonoid-enriched cocoa-derived product could potentially exert stronger health benefits. The aim of the present study was to obtain a cocoa powder with a higher flavonoid content (mainly enriched in monomer compounds) and assess its flavonoid bioavailability in humans. For this purpose, an unfermented, nonroasted, and blanch-treated cocoa powder (A) was obtained. The powder contained four times more procyanidins than a conventional (B) cocoa powder. Powder A contained eight times more epicatechin and procyanidin B2 than powder B. Cocoa milk drinks were prepared with powder A (MDA) and B (MDB). The bioavailability of flavonoids in both drinks was assessed in a crossover intervention with healthy volunteers. The content of epicatechin glucuronide, the main metabolite detected in plasma, was five-fold higher upon consumption of MDA as compared with MDB. The urinary excretion of metabolites, mainly methyl epicatechin sulfate, was higher upon MDA consumption as compared with MDB, ranging from two-to 12-fold higher depending on the metabolite. These results, together with previous reports regarding the cardiovascular benefits linked to the presence of procyanidin metabolites in plasma, suggest that further clinical trials to validate the health benefits of a flavonoid-enriched cocoa powder are warranted.

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Cocoa inhibits platelet activation and function

Abstract: Cocoa consumption suppressed ADP- or epinephrine-stimulated platelet activation and platelet microparticle formation. Cocoa consumption had an aspirin-like effect on primary hemostasis.

Cited by 315 publications

References 44 publications

Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans

Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans

Effect of Acute and Chronic Tea Consumption on Platelet Aggregation in Patients With Coronary Artery Disease

A New Process To Develop a Cocoa Powder with Higher Flavonoid Monomer Content and Enhanced Bioavailability in Healthy Humans

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