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DIFFERENTIAL EFFECT OF COCOA DRINKS WITH LOW AND HIGH THEOBROMINE DOSE ON PERIPHERAL AND CENTRAL BLOOD PRESSURE: A DOUBLE BLIND PLACEBO CONTROLLED RANDOMISED CROSS-OVER TRIAL: PP.31.219

Background: Flavonoid containing cocoa products may have a BP lowering effect. It has been suggested that theobromine, due to its vasodilatory properties, could add to this effect. We tested whether flavonoid-rich cocoa drinks low or high in theobromine could lower peripheral and central BP. Methods: In a double-blind placebo-controlled cross-over trial we assigned 42 healthy individuals (32 males, age 62 ± 4.5 yrs) with low CVD risk and office BP of 130-159/85–99 mmHg to a random treatment sequence of acidified-milk drinks containing (1) placebo, (2) cocoa powder with 500 mg flavonoids and low dose (115 mg) theobromine (LDTC) or (3) cocoa powder with 500 mg flavonoids and high dose (1000 mg) theobromine (HDTC). Treatment duration was three weeks with two weeks wash-out. Measurements were done at baseline and after each treatment period. The primary outcome was 24-hour ambulatory BP. Secondary outcome was central BP two hours after consumption of the test product. Outcomes were analysed using linear mixed models with correction for baseline measurements. Results: Treatment with placebo, LDTC and HDTC resulted in a mean 24-hour systolic and diastolic BP (±SE) of 123.9 (1.0)/ 76.4 (0.6), 125.4 (1.0)/ 77.7 (0.6) and 127.2 (1.0)/ 77.8 (0.6) mmHg, respectively (p = 0.02/p = 0.06), while central BP was 128.6 (1.5)/ 82.7 (0.9), 129.5 (1.5)/ 82.8(0.9) and 124.3 (1.5)/ 81.6 (0.9) mmHg (p = 0.001/p = 0.26). Conclusions: Treatment of flavonoid-rich cocoa drinks high in theobromine increased 24-hour ambulatory systolic BP, but lowered central systolic BP compared to placebo. There were no differences in peripheral or central systolic and diastolic BP between the cocoa drink low in theobromine and placebo.