Dark chocolate improves coronary vasomotion and reduces platelet reactivity.
BACKGROUND
Dark chocolate has potent antioxidant properties. Coronary atherosclerosis is promoted by impaired endothelial function and increased platelet activation. Traditional risk factors, high oxidative stress, and reduced antioxidant defenses play a crucial role in the pathogenesis of atherosclerosis, particularly in transplanted hearts. Thus, flavonoid-rich dark chocolate holds the potential to have a beneficial impact on graft atherosclerosis.


RESULTS
We assessed the effect of flavonoid-rich dark chocolate compared with cocoa-free control chocolate on coronary vascular and platelet function in 22 heart transplant recipients in a double-blind, randomized study. Coronary vasomotion was assessed with quantitative coronary angiography and cold pressor testing before and 2 hours after ingestion of 40 g of dark (70% cocoa) chocolate or control chocolate, respectively. Two hours after ingestion of flavonoid-rich dark chocolate, coronary artery diameter was increased significantly (from 2.36+/-0.51 to 2.51+/-0.59 mm, P<0.01), whereas it remained unchanged after control chocolate. Endothelium-dependent coronary vasomotion improved significantly after dark chocolate (4.5+/-11.4% versus -4.3+/-11.7% in the placebo group, P=0.01). Platelet adhesion decreased from 4.9+/-1.1% to 3.8+/-0.8% (P=0.04) in the dark chocolate group but remained unchanged in the control group.


CONCLUSIONS
Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption. These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration.
Flammer
Andreas J
AJ
Cardiovascular Center, Cardiology, University Hospital Zurich, Raemistr 100, CH-8091 Zurich, Switzerland.
Hermann
Frank
F
Sudano
Isabella
I
Spieker
Lukas
L
Hermann
Matthias
M
Cooper
Karen A
KA
Serafini
Mauro
M
Lüscher
Thomas F
TF
Ruschitzka
Frank
F
Noll
Georg
G
Corti
Roberto
R
D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D002099:Cacao; D002182:Candy; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005419:Flavonoids / Q000008:administration & dosage; D016027:Heart Transplantation / Q000379:methods; D006801:Humans; D010973:Platelet Adhesiveness / Q000187:drug effects* / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects* / Q000502:physiology; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
D005419:Flavonoids