Dark chocolate may be a cost effective — and palatable — option to reduce cardiovascular risk in high-risk patients, according to a new study.
To construct their model, Australian researchers used data from meta-analyses that showed dark chocolate consumption reduced systolic blood pressure by 3.2 mm Hg and LDL cholesterol by 0.15 mmol/L (roughly 6 mg/dL). The model included 2000 people with hypertension and metabolic syndrome who were free of cardiovascular disease.They calculated that over a decade, regular dark chocolate consumption could prevent 70 nonfatal cardiovascular events and 15 cardiovascular-related deaths per 10,000 population treated. The strategy would be cost effective if $42 was spent per person per year on a dark chocolate prevention strategy (e.g., advertising, educational campaigns, or chocolate subsidies). The strategy would still be cost effective with only 80% compliance. The authors conclude: “Chocolate benefits from being by and large a pleasant, and hence sustainable, treatment option. Evidence to date suggests that the chocolate would need to be dark and of at least 60-70% cocoa, or formulated to be enriched with polyphenols.” This paper published in British Medical Journal (  BMJ 2012;344:e3657   ) comes after another study showing the benefit of dark chocolate in blood pressure control. In a randomized, investigator-blinded trial, German researchers evaluated whether low doses of polyphenol-rich dark chocolate offer benefits. Forty-four adults (mean age, 64) with untreated pre- or stage 1 hypertension (mean blood pressure [BP], 147/87) received daily supplements of either dark chocolate (6.3 g — about the weight of 1.5 Hershey’s Kisses) or polyphenol-free white chocolate. Participants had no other cardiovascular or metabolic disease and maintained their usual diet and physical activity. At 18 weeks, mean systolic BP declined by 2.9 mm Hg and diastolic BP by 1.9 mm Hg in the intervention subjects, with no change in control subjects. The BP reductions were associated with a significant increase in S-nitrosoglutathione, a marker of nitric oxide activity. No significant changes were noted in weight, cholesterol profile, or other metabolic parameters.( Taubert D et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: A randomized controlled trial. JAMA 2007 Jul 4; 298:49-60.)

Comments: these remain small studies and large trials might be needed; in the meantime a little dark chocolate might be healthy treat_BA

Appeared in Physician’s First Watch