Table 2.
Studies on cardiovascular effects related to cocoa or chocolate consumption, included in this review.
| Study | Study Design | Food Type | Main Outcomes |
|---|---|---|---|
| Dong J-Y. et al. 2017 [26] | Prospective human cohort study | Chocolate | Inverse association between chocolate consumption and risk of developing stroke in women |
| Engler M.B. et al. 2004 [29] | Randomized controlled trial in human | Chocolate | Dark chocolate improved endothelial function and increased concentration of plasmatic epicatechins in healthy adults |
| Fisher N.D. & Hollenberg N.K. 2006 [30] | Randomized controlled trial in human | Cocoa | Cocoa enhanced several measures of endothelial function (nitric oxide-dependent) to a greater degree among older, in whom endothelial function is more disturbed, than younger healthy subjects |
| Fisher N.D. et al. 2003 [31] | Randomized controlled trial in human | Cocoa | Cocoa induced vasodilation via activation of the nitric oxide system, providing a plausible mechanism for the protection that flavanol-rich foods induce against coronary events |
| Murphy K.J. et al. 2003 [33] | Randomized, double-blind, placebo-controlled study | Cocoa | Cocoa flavanol and procyanidin supplementation significantly increased plasma epicatechin and catechin concentrations and significantly decreased platelet function |
| Schramm D.D. et al. 2003 [34] | Randomized controlled trial in human | Cocoa | Valuating the food effects on the absorption and pharmacokinetics of cocoa flavanols, carbohydrates increased oral flavanol absorption |
| Schwab U.S. et al. 1996 [35] | Randomized crossover trial in human | Cocoa | Palmitic acid-enriched diet (using palm oil) increased serum lipids, lipoproteins and plasma cholesteryl ester transfer protein activity compared with the stearic acid-enriched diet (using cocoa butter) |
| Pereira T. et al. 2019 [37] | Randomized double-blind trial in human | Chocolate | Cocoa-rich chocolate improved vascular function by reducing central brachial artery pressures and promoting vascular relaxation in young, healthy adults |
| Larsson S.C. et al. 2016 [38] | Prospective human study | Chocolate | Chocolate consumption was associated with lower risk of myocardial infarction and ischemic heart disease |
| Greenberg J.A. et al. 2018 [39] | Prospective human study | Chocolate | No association between chocolate intake and risk of coronary heart disease, stroke, or both combined was observed |
| Khawaja O. et al. 2015 [40] | Randomized double-blind controlled human study | Chocolate | No support to association between chocolate consumption and risk of atrial fibrillation among male physicians |
| Kwok C.S. et al. 2016 [41] | Prospective human study | Chocolate | Habitual chocolate consumption was not associated with the risk of incident heart failure among healthy men and women |
| Steinhaus D.A. et al. 2017 [43] | Prospective cohort human study | Chocolate | J-shaped relationship between chocolate consumption and heart failure incidence |
| Francis S.T. et al. 2006 [44] | Randomized controlled trial in human | Cocoa | Measurements of arterial spin labeling cerebral blood flow demonstrated an increase in blood flow after ingestion of flavanol-rich cocoa, suggesting its potential use for treatment of vascular impairment |
| Walters M.R. et al. 2013 [45] | Randomized controlled trial in human | Chocolate | Chocolate consumption is associated with an acute change in cerebral vasomotor reactivity, independent of metabolic and hemodynamic parameters. |