Effects on Peripheral and Central Blood Pressure of Cocoa With Natural or High-Dose Theobromine

Abstract

Abstract-Flavanol-rich cocoa products have been reported to lower blood pressure. It has been suggested that theobromine is partially responsible for this effect. We tested whether consumption of flavanol-rich cocoa drinks with natural or added theobromine could lower peripheral and central blood pressure. In a double-blind, placebo-controlled 3-period crossover trial we assigned 42 healthy individuals (age 62Ϯ4.5 years; 32 men) with office blood pressure of 130 to 159 mm Hg/85 to 99 mm Hg and low added cardiovascular risk to a random treatment sequence of dairy drinks containing placebo, flavanol-rich cocoa with natural dose consisting of 106 mg of theobromine, or theobromineenriched flavanol-rich cocoa with 979 mg of theobromine. Treatment duration was 3 weeks with a 2-week washout. The primary outcome was the difference in 24-hour ambulatory systolic blood pressure between placebo and active treatment after 3 weeks. The difference in central systolic blood pressure between placebo and active treatment was a secondary outcome. Treatment with theobromine-enriched cocoa resulted in a meanϮSE of 3.2Ϯ1.1 mm Hg higher 24-hour ambulatory systolic blood pressure compared with placebo (PϽ0.01). In contrast, 2 hours after theobromineenriched cocoa, laboratory peripheral systolic blood pressure was not different from placebo, whereas central systolic blood pressure was 4.3Ϯ1.4 mm Hg lower (Pϭ0.001). Natural dose theobromine cocoa did not significantly change either 24-hour ambulatory or central systolic blood pressure compared with placebo. In conclusion, theobromine-enriched cocoa significantly increased 24-hour ambulatory systolic blood pressure while lowering central systolic blood pressure. (Hypertension. 2010;56:839-846.)Key Words: cocoa Ⅲ theobromine Ⅲ blood pressure Ⅲ hemodynamics Ⅲ aortic pressure waveform T he consumption of foods and beverages rich in flavanols has been associated with a decreased risk of cardiovascular morbidity and mortality. [1][2][3] In Western society, a large proportion of flavanol intake is through cocoa and cocoacontaining products. One of the mechanism by which cocoa could exert its presumed beneficial effects on cardiovascular disease is by lowering blood pressure (BP). There is, however, discussion about the BP-lowering potential of cocoa. A recent meta-analysis of intervention studies looking at the BP-lowering effect of flavanol-rich cocoa found a significant reduction of 4.5 mm Hg for systolic BP (SBP) and 2.5 mm Hg for diastolic BP (DBP). 4 However, most of the clinical trials in the analysis lacked adequate control treatment, and studies that included a proper control group all showed a neutral effect on DBP and SBP. [5][6][7] Other than a possible effect on peripheral (brachial) BP, cocoa intake may improve central hemodynamics. Central BP is thought to be an important determinant of hypertensive organ damage and might be superior to peripheral BP in predicting cardiovascular disease. 8 In a cross-sectional study in healthy individuals, increasing amounts of cocoa consumption...

Influence of drying methods on cocoa (Theobroma cacao L.): antioxidant activity and presence of ochratoxin A

“…This fact is very important from a health perspective because caffeine acts as a stimulant and vasoconstrictor, whereas theobromine acts as a vasodilator and lowers blood pressure. Furthermore, theobromine acts as a muscle relaxant and diuretic (Van den Bogaard et al, 2010).…”

Protective Effects of Flavanol-Rich Dark Chocolate on Endothelial Function and Wave Reflection During Acute Hyperglycemia

“…This is of interest, as additional mechanisms of action of cocoa flavanol appear to exist (eg, via modulation of the reninangiotensin system), 37 and other cocoa constituents such as theobromine and caffeine may also contribute partly to the observed changes in FMD and wave reflections. One study of theobromine from dark chocolate, however, found no hemodynamic or electrophysiological effects in young adults 38 ; another found the caffeine and theobromine content of flavanolpoor chocolate were similar to that of flavanol-rich chocolate, although only dark chocolate affected vascular function and NO bioavailability, 39 and van den Bogaard et al 40 reported naturaldose theobromine cocoa did not significantly change either 24-hour ambulatory or central SBP compared with placebo.…”

Bioactive compounds in different cocoa (Theobroma cacao, L) cultivars during fermentation

“…The other aspect is the effect of methylxantines in human body, since caffeine is well known for its action in central nervous system promoting a stimulating effect, increasing the sense of allarm, vitality, psychomotor reactions and rising the blood pressure. Dn the other hand, theobromine has no stimulating effect, because the action of theobromine in the central nervous system is very weak or almost non-existent, but it can act as a vasodilator, a muscle relaxant, diuretic and blood pressure reducer (Van den Bogaard et al, 2010;Mitchell et al, 2011).…”

“…While caffeine has a stimulating effect on the brain, increasing the psychomotor reactions and blood pressure, the theobromine acts as a muscle relaxant, diuretic and blood pressure reducer (Van den Bogaard et al, 2010;Bruinsma & Taren, 1999).…”