People who have high blood pressure (hypertension) are at a higher risk of developing heart disease and stroke, which are two of the leading causes of death in the United States.
According to the Centers for Disease Control and PreventionTrusted Source (CDC), 116 million American adults have high blood pressure — nearly half of all adults — and many do not have it under control.
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"Almost every organ in the body is affected by hypertension," Dr. Michael Goyfman, chief of cardiology and director of echocardiography at Long Island Jewish Forest Hills hospital in Queens, New York, told Healthline. "It can cause strokes, heart attacks, and kidney damage, among other complications, if left untreated."
People with high blood pressure are frequently advised to follow heart-healthy dietary protocols.
A new study published in Frontiers in Nutrition suggests that eating flavanol-rich cocoa may help lower blood pressure and reduce arterial stiffness, potentially opening up new avenues for future treatments.
Blood pressure and cocoa flavanols
Flavanols are a plant-based compound found in common foods and beverages such as tea, blueberries, red wine, and cocoa.
Cocoa is derived from cocoa beans, which are the fatty seeds of the Theobroma cacao tree. Cocoa, which is high in flavanols, is thought to lower blood pressure.
Prior research has shown that flavanol-rich cocoa and chocolate products reduce blood pressure in healthy adults in the short term. However, the long-term consequences are not fully understood.
Researchers from the University of Surrey set out to see if cocoa flavanols could lower blood pressure in healthy adults without lowering it on days when it was already under control.
On alternate days, researchers gave 11 participants six cocoa flavanol capsules (approximately 860 milligrams) or six placebo capsules containing brown sugar.
To assess arterial stiffness, the participants were also given an upper arm blood pressure monitor and a finger clip measuring pulse wave velocity (PWV).
"High blood pressure and arterial stiffness increase a person's risk of heart disease and stroke," Christian Heiss, professor of Cardiovascular Medicine at the University of Surrey, said in a statement.
When blood pressure was low, there was no effect.
Prior to consuming the cacao capsules, participants' blood pressure and PWV were measured, as well as every 30 minutes afterward for the first three hours, and then every hour for the next nine hours.
According to the study findings, systolic blood pressure was reduced by about 1.4 mmHg after 12 hours.
The effects were also detected 8 hours after consuming cocoa, a "second peak" that the researchers believe is due to how gut bacteria metabolize the flavanols.
Researchers also discovered that participants' blood pressure and arterial stiffness were only reduced when they were high, and there was no effect when their blood pressure was low in the morning.
Could cocoa help with hypertension?
According to a press release, the new study "reduces concerns that cocoa as a treatment for high blood pressure may pose health risks by lowering blood pressure when it is not elevated."
This means that cocoa could be used in clinical settings.
Nonetheless, Dr. Mehrdad Rezaee, a cardiologist at O'Connor Hospital in San Jose, California, who was not involved in the study, pointed out some limitations of the new research.
"Researchers did not test this substance over an extended period of time or in a clinically relevant situation," Rezaee explained. "At the moment, this is still a hypothesis that was addressed in a very controlled environment."
The findings were not clinically significant.
"Healthy people have a range of blood pressures throughout the day," Dr. Jill Grounds, a cardiologist with Memorial Hermann Medical Group, explained. "Normal blood pressure isn't a fixed 120/80."
The discovery of a "smart" blood pressure drug is "big news," according to Grounds.
"If a'smart' medication was developed that had varying effects based on need — increasing effect at times of higher blood pressure and decreasing effect at times of lower blood pressure," Grounds said.
Regardless of these implications, Grounds stressed that the magnitude of the effect seen in this study is not clinically significant.
"The majority of antihypertensive medications reduce systolic blood pressure by at least 10-15mmHg," she explained.
The results should be interpreted with caution.
The study is "thought-provoking," according to Dr. Eric Stahl, a diagnostic cardiology and prevention expert at Staten Island University Hospital, but should be interpreted with caution.
"This small study of healthy volunteers found a minimal reduction in blood pressure in the hours following ingestion of 862 mg cocoa flavanol," Stahl said.
"While it is intriguing to consider the potential physiologic effects of cocoa on blood pressure, more research is required before we can include it in hypertension treatment."
He also stated that the reduction observed by the participants was unlikely to have a significant clinical impact.
Dietary guidelines for heart health
Stahl expressed concern that people suffering from hypertension, diabetes, or obesity will interpret this study as a recommendation to consume chocolate products high in sugar and fat.
"I would like to see a more robust response in patients with hypertension," Stahl said.
"For the time being, I always recommend the DASH and Mediterranean diets to my hypertensive patients."
In conclusion
New research suggests that cocoa flavanols can safely lower blood pressure in healthy people, but more research is needed to determine whether cocoa products can help treat hypertension.
While some experts believe the findings could pave the way for new treatments, the results were not clinically significant due to the small size of the study.
People with high blood pressure and other chronic conditions should avoid eating more chocolate, which is high in sugar and fat.
To help reduce high blood pressure, experts recommend heart-healthy dietary protocols such as the DASH and Mediterranean diets.
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