title: Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults.
abstract: OBJECTIVE
  To investigate the association of chocolate consumption with measured blood pressure (BP) and the incidence of cardiovascular disease (CVD).
  
  
  RESULTS
  Dietary intake, including chocolate, and BP were assessed at baseline (1994-98) in 19 357 participants (aged 35-65 years) free of myocardial infarction (MI) and stroke and not using antihypertensive medication of the Potsdam arm of the European Prospective Investigation into Cancer and Nutrition. Incident cases of MI (n = 166) and stroke (n = 136) were identified after a mean follow-up of approximately 8 years. Mean systolic BP was 1.0 mmHg [95% confidence interval (CI) -1.6 to -0.4 mmHg] and mean diastolic BP 0.9 mmHg (95% CI -1.3 to -0.5 mmHg) lower in the top quartile compared with the bottom quartile of chocolate consumption. The relative risk of the combined outcome of MI and stroke for top vs. bottom quartiles was 0.61 (95% CI 0.44-0.87; P linear trend = 0.014). Baseline BP explained 12% of this lower risk (95% CI 3-36%). The inverse association was stronger for stroke than for MI.
  
  
  CONCLUSIONS
  Chocolate consumption appears to lower CVD risk, in part through reducing BP. The inverse association may be stronger for stroke than for MI. Further research is needed, in particular randomized trials.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany. brian.buijsse@dife.de
authors.forename: Brian
authors.initials: B
authors.lastname: Buijsse
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Dagmar
authors.initials: D
authors.lastname: Drogan
authors.forename: Manuela
authors.initials: M
authors.lastname: Bergmann
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002099:Cacao; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires