Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives
Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives
复制标题
DOI：
10.1161/01.hyp.0000174990.46027.70
复制
发表时间：
2005-08-01
期刊：
影响因子：
8.3
通讯作者：
Ferri, C
中科院分区：
文献类型：
--
作者：
Grassi, D;Necozione, S;Ferri, C
食用富含黄烷醇的黑巧克力(DC)可以降低健康受试者的血压(BP)和胰岛素抵抗，这表明对原发性高血压(EH)患者有类似的好处。因此，我们测试了DC对EH患者24小时动态血压、血流介导的扩张(FMD)和口服葡萄糖耐量试验(OGTTS)的影响。经过7天的无巧克力磨合阶段后，20名从未接受治疗的I级EH患者(男性10例，年龄43.7+/-7.8岁)被随机分为两组，一组每天服用100克DC(含88 mg黄烷醇)，另一组每天服用90g无黄烷醇的白巧克力(WC)，持续15天。在第二次7天不吃巧克力后，患者被转移到另一种治疗。在每次治疗结束时评估无创性24小时动态血压、FMD、OGTT、血清胆固醇和血管炎症标志物。根据OGTT值计算胰岛素抵抗的稳态模型评估(HOMA-IR)、定量胰岛素敏感性检查指数(QUICI)和胰岛素敏感性指数(ISI)。DC后动态血压下降(24小时收缩压-11.9+/-7.7 mm Hg，P<；0.0001；24小时舒张压-8.5+/-5.0 mm Hg，P<；0.0001)，但没有WC。DC而不是WC降低了HOMA-IR(P<；0.0001)，但改善了Quicki、ISI和FMD。丹参还能降低血清低密度脂蛋白胆固醇(从3.4+/-0.5降至3.0+/-0.6 mmol/L；P<；0.05)。综上所述，DC可降低高血压患者的血压和血清低密度脂蛋白，改善FMD，改善胰岛素敏感性。这些结果表明，在平衡总卡路里摄入量的同时，如果将可可产品中的黄烷醇作为EH患者健康饮食的一部分，可能会提供一些心血管益处。
Consumption of flavanol-rich dark chocolate (DC) has been shown to decrease blood pressure (BP) and insulin resistance in healthy subjects, suggesting similar benefits in patients with essential hypertension ( EH). Therefore, we tested the effect of DC on 24-hour ambulatory BP, flow-mediated dilation (FMD), and oral glucose tolerance tests (OGTTs) in patients with EH. After a 7-day chocolate-free run-in phase, 20 never-treated, grade I patients with EH ( 10 males; 43.7 +/- 7.8 years) were randomized to receive either 100 g per day DC ( containing 88 mg flavanols) or 90 g per day flavanol-free white chocolate (WC) in an isocaloric manner for 15 days. After a second 7-day chocolate-free period, patients were crossed over to the other treatment. Noninvasive 24-hour ambulatory BP, FMD, OGTT, serum cholesterol, and markers of vascular inflammation were evaluated at the end of each treatment. The homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and insulin sensitivity index (ISI) were calculated from OGTT values. Ambulatory BP decreased after DC ( 24- hour systolic BP - 11.9 +/- 7.7 mm Hg, P < 0.0001; 24-hour diastolic BP - 8.5 +/- 5.0 mm Hg, P < 0.0001) but not WC. DC but not WC decreased HOMA-IR ( P < 0.0001), but it improved QUICKI, ISI, and FMD. DC also decreased serum LDL cholesterol ( from 3.4 +/- 0.5 to 3.0 +/- 0.6 mmol/L; P < 0.05). In summary, DC decreased BP and serum LDL cholesterol, improved FMD, and ameliorated insulin sensitivity in hypertensives. These results suggest that, while balancing total calorie intake, flavanols from cocoa products may provide some cardiovascular benefit if included as part of a healthy diet for patients with EH.