Article

AGE

, 37:56

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial

  • Christian HeissAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty Email author  
  • , Roberto SansoneAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty 
  • , Hakima KarimiAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Moritz KrabbeAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Dominik SchulerAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Ana Rodriguez-MateosAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Thomas KraemerAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Miriam Margherita Cortese-KrottAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
  • , Gunter G. C. KuhnleAffiliated withDepartment of Food and Nutritional Sciences, University Reading
    • , Jeremy P. E. SpencerAffiliated withDepartment of Food and Nutritional Sciences, University Reading
    • , Hagen SchroeterAffiliated withMars Inc.
    • , Marc W. MerxAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty
    • , Malte KelmAffiliated withDivision of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical FacultyCardiovascular Research Institute Duesseldorf, University Duesseldorf, Medical Faculty
    • , for the FLAVIOLA Consortium, European Union 7th Framework Program

Abstract

Increased vascular stiffness, endothelial dysfunction, and isolated systolic hypertension are hallmarks of vascular aging. Regular cocoa flavanol (CF) intake can improve vascular function in healthy young and elderly at-risk individuals. However, the mechanisms underlying CF bioactivity remain largely unknown. We investigated the effects of CF intake on cardiovascular function in healthy young and elderly individuals without history, signs, or symptoms of cardiovascular disease by applying particular focus on functional endpoints relevant to cardiovascular aging. In a randomized, controlled, double-masked, parallel-group dietary intervention trial, 22 young (<35 years) and 20 elderly (50–80 year) healthy, male non-smokers consumed either a CF-containing drink (450 mg CF) or nutrient-matched, CF-free control drink bi-daily for 14 days. The primary endpoint was endothelial function as measured by flow-mediated vasodilation (FMD). Secondary endpoints included cardiac output, vascular stiffness, conductance of conduit and resistance arteries, and perfusion in the microcirculation. Following 2 weeks of CF intake, FMD improved in young (6.1 ± 0.7 vs. 7.6 ± 0.7 %, p < 0.001) and elderly (4.9 ± 0.6 vs. 6.3 ± 0.9 %, p < 0.001). Secondary outcomes demonstrated in both groups that CF intake decreased pulse wave velocity and lowered total peripheral resistance, and increased arteriolar and microvascular vasodilator capacity, red cell deformability, and diastolic blood pressure, while cardiac output remained affected. In the elderly, baseline systolic blood pressure was elevated, driven by an arterial-stiffness-related augmentation. CF intake decreased aortic augmentation index (−9 %) and thus systolic blood pressure (−7 mmHg; Clinicaltrials.gov: NCT01639781). CF intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.

Keywords

Age Blood pressure Arterial stiffness Endothelial function Nutrition