title: Low vs. higher-dose dark chocolate and blood pressure in cardiovascular high-risk patients.
abstract: BACKGROUND
  Dark chocolate may have blood pressure-lowering properties. We conducted a prospective randomized open-label blinded end-point design trial to study a potential dose dependency of the presumed antihypertensive effect of dark chocolate by directly comparing low vs. higher doses of dark chocolate over the course of 3 months.
  
  
  METHODS
  We enrolled a total of 102 patients with prehypertension/stage 1 hypertension and established cardiovascular end-organ damage or diabetes mellitus. Patients were randomly assigned to receive either 6 or 25 g/day of flavanol-rich dark chocolate for 3 months. The difference in 24-h mean blood pressure between groups was defined as the primary outcome measure.
  
  
  RESULTS
  Significant reductions in mean ambulatory 24-h blood pressure were observed between baseline and follow-up in both groups (6 g/day: -2.3 mm Hg, 95% confidence interval -4.1 to -0.4; 25 g/day: -1.9 mm Hg, 95% confidence interval -3.6 to -0.2). There were no significant differences in blood pressure changes between groups. In the higher-dose group, a slight increase in body weight was noted (0.8 kg, 95% confidence interval 0.06 to 1.6).
  
  
  CONCLUSIONS
  The findings are consistent with the hypothesis that dark chocolate may be associated with a reduction in blood pressure (BP). However, due to the lack of a control group, confounding may be possible and the results should be interpreted with caution.
authors.affiliation: Department of Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. stdesch@web.de
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.forename: Daniela
authors.initials: D
authors.lastname: Kobler
authors.forename: Johanna
authors.initials: J
authors.lastname: Schmidt
authors.forename: Melanie
authors.initials: M
authors.lastname: Sonnabend
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sareban
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.forename: Matthias
authors.initials: M
authors.lastname: Blüher
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002099:Cacao; D002182:Candy; D002318:Cardiovascular Diseases / Q000209:etiology; D048909:Diabetes Complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D012306:Risk