title: [Cacoa and dark chocolate in cardiovascular prevention?].
abstract: It has been shown that the consumption of cocoa has a positive influence on a                     number of cardiovascular surrogate parameters such as arterial vasodilatation                     and a moderate decrease in blood pressure in humans. In the blood, a decrease in                     platelet aggregation and an increase in angiogenetic progenitor cells was noted.                     Furthermore, anti-inflammatory effects, an amelioration of the lipid profile and                     glucose metabolism was described. An increase of endothelial NO production                     following the ingestion of the antioxidant cocoa flavanols catechin and                     epicatechin seems to be the leading mechanism causing these effects. In animal                     studies of myocardial reperfusion, a decrease in infarct size was noted. In                     several prospective cohort studies from Europe and the United States, a 50 %                     reduction of mortality mostly due to a reduction of myocardial infarction was                     published. Consumption up to about 25 g daily of a flavanol rich dark chocolate                     (ca. 85 % cocoa content) can be recommended for cardiovascular prevention. In                     this moderate dosage, the potentially harmful effects due to weight gain and                     cadmium intake will be minimal. However, controlled randomized trials with well                     defined clinical endpoints are needed to prove the positive effects described so                     far. At this point, in time based on the information described in this article,                     a moderate consumption of flavanol rich cocoa products seems to be effective in                     the prevention of coronary artery disease and myocardial infarction.
authors.affiliation: Praxis für Innere Medizin, Kardiologie, Klinische Pharmakologie, Wiesbaden.
authors.forename: G G
authors.initials: GG
authors.lastname: Belz
authors.forename: S
authors.initials: S
authors.lastname: Mohr-Kahaly
mesh_terms: D001682:Biological Availability; D002099:Cacao; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003327:Coronary Disease / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000187:drug effects; D005419:Flavonoids; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control*; D009569:Nitric Oxide / Q000378:metabolism
chemical_list: D005419:Flavonoids; D009569:Nitric Oxide