title: Cocoa, blood pressure, and cardiovascular health.
abstract: High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferri
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Giovambattista
authors.initials: G
authors.lastname: Desideri
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Ferri
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Proietti
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Di Agostino
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Martella
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mai
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Giosia
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila , 67100 Coppito, L'Aquila, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Grassi
mesh_terms: D000818:Animals; D001794:Blood Pressure; D002099:Cacao / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000378:metabolism* / Q000503:physiopathology*; D002319:Cardiovascular System / Q000378:metabolism; D006801:Humans; D010936:Plant Extracts / Q000378:metabolism*
chemical_list: D010936:Plant Extracts
keywords: blood pressure; cardiovascular health; cocoa; endothelium; polyphenols