Dose and response to cocoa (DARC): A randomized double-blind controlled trial

Background

Habitual cocoa consumption has been shown to improve cardiometabolic risk. This study compared the effects of two doses of cocoa on blood pressure and other cardiometabolic risk factors in adults with stage 1 hypertension.

Methods

Randomized, controlled, modified Latin square parallel design to compare effects of two daily doses (i.e., 5 vs. 10 g) of cocoa powder in cocoa-containing products for 8 weeks on cardio-metabolic risk factors in 122 adults (average age 53.6 years; 63 women and 59 men) with stage 1 hypertension on no more than one medication.

Results

Daily cocoa consumption did not improve (p > 0.05) blood pressure, endothelial function, lipid profile, or insulin resistance in analyses of our entire sample. Daily consumption of cocoa, compared to placebo, reduced blood pressure in participants on ACE inhibitors (24-hour SBP: − 3.2 ± 9.3 vs. 3.6 ± 8.5; p = 0.038, 24-hour DBP: − 2.0 ± 5.0 vs. 2.3 ± 5.6 mm Hg; p = 0.023), beta blockers (− 4.6 ± 3.2 vs. 1.8 ± 2.8 mm Hg; p = 0.009) or diuretics (24-hour SBP 5.5 ± 7.4 vs. − 0.6 ± 4.7; p = 0.022); and improved endothelial function (3.1 ± 2.3 vs. − 3.4 ± 7.4%; p = 0.031) in participants on beta blockers. Dose-response on blood pressure was evident in participants on ACE inhibitors, with more benefit from the high dose compared to the low dose.

Conclusions

Including cocoa in the diet of patients with stage 1 hypertension seems to exert differential beneficial effects on cardiometabolic risk factors in certain sub-groups of patients.