Effects of high flavanol dark chocolate on cardiovascular function and platelet aggregation

Rull, Gurvinder; Zain, Zetty Nadia Mohd; Shiel, Julian; Lundberg, Martina H.; Johnston, Atholl; Warner, Timothy D.; Corder, Roger

doi:10.1016/j.vph.2015.02.010

Cited by 44 publications

(36 citation statements)

References 50 publications

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“…However, to completely metabolize the lipids intake, sampling after at least 8 h (better 12 h) fasting and reduced activity (bed rest) is recommended [4, 38]. It is also advisable not to eat dark chocolate [39]. …”

Section: Methodsmentioning

confidence: 99%

“…About dark chocolate, platelet aggregation is modulated by a flavanol-independent mechanism that is likely due to theobromine which is containing by cocoa products [39]. …”

Section: Methodsmentioning

confidence: 99%

“…For specialized coagulation testing, most samples are sent as frozen samples, whilst samples for routine coagulation are more often sent as citrated blood (primary tube). Ideally, the primary tube should be received together with the aliquot tube [39]. It is not suggested to recentrifuge the aliquots coming from external laboratories.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Magnette¹,

Chatelain²,

Châtelain³

et al. 2016

Thrombosis J

103

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Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results.Pre-analytical errors may occur throughout the testing process and arise from unsuitable, inappropriate or wrongly handled procedures. Problems may arise during the collection of blood specimens such as misidentification of the sample, use of inadequate devices or needles, incorrect order of draw, prolonged tourniquet placing, unsuccessful attempts to locate the vein, incorrect use of additive tubes, collection of unsuitable samples for quality or quantity, inappropriate mixing of a sample, etc. Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage.Laboratory errors can often have serious adverse consequences. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can also have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as “diagnostic”. Controlling pre-analytical variables is critical since this has a direct influence on the quality of results and on their clinical reliability. The accurate standardization of the pre-analytical phase is of pivotal importance for achieving reliable results of coagulation tests and should reduce the side effects of the influence factors. This review is a summary of the most important recommendations regarding the importance of pre-analytical factors for coagulation testing and should be a tool to increase awareness about the importance of pre-analytical factors for coagulation testing.

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Section: Methodsmentioning

confidence: 99%

“…About dark chocolate, platelet aggregation is modulated by a flavanol-independent mechanism that is likely due to theobromine which is containing by cocoa products [39]. …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Magnette¹,

Chatelain²,

Châtelain³

et al. 2016

Thrombosis J

103

View full text Add to dashboard Cite

show abstract

“…Besides, the milk in milk-chocolate interferes with the absorption of cacao polyphenols [89]. Consumption of cocoa-rich food, such as dark chocolate, is associated with a reduced risk for vascular disease [90][91][92][93][94]. This is due to the action of flavan-3-ols which augment endothelial NOS and thereby enhance the production of nitric oxide (NO), thereby improving endothelium-dependant vasorelaxation [95].…”

Section: Cacaomentioning

confidence: 99%

“…This is due to the action of flavan-3-ols which augment endothelial NOS and thereby enhance the production of nitric oxide (NO), thereby improving endothelium-dependant vasorelaxation [95]. Cacao decreases blood pressure [96,97], increases insulin sensitivity [96], increases HDL cholesterol concentrations [98] and reduces blood platelet stickiness and clotting [91,92].…”

Section: Cacaomentioning

confidence: 99%

Nutritional recommendations for individuals with Flammer syndrome

et al. 2017

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The Flammer syndrome (FS) describes the phenotype of people with a predisposition for an altered reaction of the blood vessels to stimuli like coldness or emotional stress.The question whether such people should be treated is often discussed. On the one hand, most of these subjects are healthy; on the other hand, FS seems to predispose to certain eye diseases such as normal tension glaucoma or retinitis pigmentosa or systemic diseases such as multiple sclerosis or tinnitus. A compromise between doing nothing and a drug treatment is the adaption of nutrition. But what do we mean by healthy food consumption for subjects with FS? The adaption of nutrition depends on the health condition. Whereas patients with e.g. a metabolic syndrome should reduce their calorie intake, this can be counterproductive for subjects with FS, as most subjects with FS have already a low body mass index (BMI) and the lower the BMI the stronger the FS symptoms. Accordingly, while fasting is healthy e.g. for subjects with metabolic syndrome, fasting can even dangerously aggravate the vascular dysregulation, as it has been nicely demonstrated by the loss of retinal vascular regulation during fasting. To give another example, while reducing salt intake is recommended for subjects with systemic hypertensions, such a salt restriction can aggravate systemic hypotension and thereby indirectly also the vascular regulation in subjects with FS. This clearly demonstrates that such a preventive adaption of nutrition needs to be personalized.

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Effect of cocoa on blood pressure

Ried

Fakler

Stocks

2017

Cochrane Database of Systematic Reviews

149

137

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BackgroundHigh blood pressure is an important risk factor for cardiovascular disease, contributing to about 50% of cardiovascular events worldwide and 37% of cardiovascular-related deaths in Western populations. Epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. Flavanols found in cocoa have been shown to increase the formation of endothelial nitric oxide which promotes vasodilation and therefore blood pressure reduction. Here we update previous meta-analyses on the e ect of cocoa on blood pressure. ObjectivesTo assess the e ects on blood pressure of chocolate or cocoa products versus low-flavanol products or placebo in adults with or without hypertension when consumed for two weeks or longer. Search methodsThis is an updated version of the review initially published in 2012. In this updated version, we searched the following electronic databases from inception to November 2016: Cochrane Hypertension Group Specialised Register, CENTRAL, MEDLINE and Embase. We also searched international trial registries, and the reference lists of review articles and included trials. Selection criteriaRandomised controlled trials (RCTs) investigating the e ects of chocolate or cocoa products on systolic and diastolic blood pressure in adults for a minimum of two weeks duration. Data collection and analysisTwo review authors independently extracted data and assessed the risks of bias in each trial. We conducted random-e ects meta-analyses on the included studies using Review Manager 5. We explored heterogeneity with subgroup analyses by baseline blood pressure, flavanol content of control group, blinding, age and duration. Sensitivity analyses explored the influence of unusual study design. Main resultsThirty-five trials (including 40 treatment comparisons) met the inclusion criteria. Of these, we added 17 trials (20 treatment comparisons) to the 18 trials (20 treatment comparisons) in the previous version of this updated review.Trials provided participants with 30 to 1218 mg of flavanols (mean = 670 mg) in 1.4 to 105 grams of cocoa products per day in the active intervention group. The control group received either a flavanol-free product (n = 26 treatment comparisons) or a low-flavanol-containing cocoa powder (range 6.4 to 88 mg flavanols (mean = 55 mg, 13 treatment comparisons; 259 mg, 1 trial).

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Effects of high flavanol dark chocolate on cardiovascular function and platelet aggregation

Cited by 44 publications

References 50 publications

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Nutritional recommendations for individuals with Flammer syndrome

Effect of cocoa on blood pressure

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