title: Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.
abstract: Increased vascular stiffness, endothelial dysfunction, and isolated systolic hypertension are hallmarks of vascular aging. Regular cocoa flavanol (CF) intake can improve vascular function in healthy young and elderly at-risk individuals. However, the mechanisms underlying CF bioactivity remain largely unknown. We investigated the effects of CF intake on cardiovascular function in healthy young and elderly individuals without history, signs, or symptoms of cardiovascular disease by applying particular focus on functional endpoints relevant to cardiovascular aging. In a randomized, controlled, double-masked, parallel-group dietary intervention trial, 22 young (<35 years) and 20 elderly (50-80 year) healthy, male non-smokers consumed either a CF-containing drink (450 mg CF) or nutrient-matched, CF-free control drink bi-daily for 14 days. The primary endpoint was endothelial function as measured by flow-mediated vasodilation (FMD). Secondary endpoints included cardiac output, vascular stiffness, conductance of conduit and resistance arteries, and perfusion in the microcirculation. Following 2 weeks of CF intake, FMD improved in young (6.1 ± 0.7 vs. 7.6 ± 0.7 %, p < 0.001) and elderly (4.9 ± 0.6 vs. 6.3 ± 0.9 %, p < 0.001). Secondary outcomes demonstrated in both groups that CF intake decreased pulse wave velocity and lowered total peripheral resistance, and increased arteriolar and microvascular vasodilator capacity, red cell deformability, and diastolic blood pressure, while cardiac output remained affected. In the elderly, baseline systolic blood pressure was elevated, driven by an arterial-stiffness-related augmentation. CF intake decreased aortic augmentation index (-9 %) and thus systolic blood pressure (-7 mmHg; Clinicaltrials.gov: NCT01639781). CF intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Moorenstr. 5, 40225, Duesseldorf, Germany, christian.heiss@med.uni-duesseldorf.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Heiss
authors.forename: Roberto
authors.initials: R
authors.lastname: Sansone
authors.forename: Hakima
authors.initials: H
authors.lastname: Karimi
authors.forename: Moritz
authors.initials: M
authors.lastname: Krabbe
authors.forename: Dominik
authors.initials: D
authors.lastname: Schuler
authors.forename: Ana
authors.initials: A
authors.lastname: Rodriguez-Mateos
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraemer
authors.forename: Miriam Margherita
authors.initials: MM
authors.lastname: Cortese-Krott
authors.forename: Gunter G C
authors.initials: GG
authors.lastname: Kuhnle
authors.forename: Jeremy P E
authors.initials: JP
authors.lastname: Spencer
authors.forename: Hagen
authors.initials: H
authors.lastname: Schroeter
authors.forename: Marc W
authors.initials: MW
authors.lastname: Merx
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000502:physiology; D002099:Cacao; D002302:Cardiac Output / Q000187:drug effects; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects; D004907:Erythrocyte Deformability / Q000187:drug effects; D044948:Flavonols / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D014655:Vascular Resistance / Q000187:drug effects; D059289:Vascular Stiffness / Q000187:drug effects*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D044948:Flavonols