Effects of Dark Chocolate on Cardiovascular Risk

Abstract

Cocoa is rich in polyphenols, a subgroup of dietary flavonoids, which seems to be able to reduce cardiovascular risk. Since dark chocolate is popular in Europe and the United States, and it is a potent source of polyphenols, there is increasing interest on its potential effects on cardiovascular risk. Evidence suggests that dark chocolate has some beneficial effects on cardiovascular risk factors, particularly on atherogenic dyslipidemia. Beneficial effects include the reduction of elevated blood pressure in hypertensive subjects, the increase in vasodilatation with improved endothelial function, as well as the inhibition of platelet activation and function. In addition, dark chocolate seems to reduce C-reactive protein concentrations and to modulate atherogenic dyslipidemia, reducing plasma total-cholesterol, LDL-cholesterol and triglyceride levels, with a concomitant increase in HDL-cholesterol concentrations. Yet, further studies are needed before recommending habitual dark chocolate consumption for the reduction of cardiovascular risk. I N T R O D U C T I O N Dark chocolate is a potent source of flavonoids, which have been proposed as a key protective dietary component able to reduce cardiovascular risk. These agents are polyphenolic compounds ubiquitous in fruits and vegetables, and appear in higher concentrations in the form of flavonols in cocoa, with beneficial antioxidant effects. In addition, flavonoids are known to suppress inflammation, by inhibiting the cyclooxygenase-2, an enzyme that up-regulates during inflammation, as well as some types of tumor formation. Recent evidence also suggests that some flavanols may inhibit atherogenesis, by the interaction with beta-platelet derived growth factor. Further beneficial effects include the reduction of elevated blood pressure in hypertensive subjects, the increase in vasodilatation with improved endothelial function, as well as the inhibition of platelet activation and function. In addition, dark chocolate seems to reduce C-reactive protein concentrations and to modulate atherogenic dyslipidemia, reducing plasma total-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglyceride levels, with a concomitant increase in high-density lipoprotein (HDL)-cholesterol concentrations. This represents a very important point, since atherogenic dyslipidemia is strongly associated with cardiovascular risk. EDITORIAL Department of Internal Medicine and Emerging Diseases, University of Palermo, Italy HOSPITAL CHRONICLES 2010, 5(2): 56–58