Cocoa effects on blood pressure, endothelial function, and inflammation: a systematic review


  • Caroline Antunes Reveles de Souza
  • Gisele Carvalho de Souza
  • Thairini de Souza Miguel
  • Jorge da Silva Pinho Junior
  • Andrea Cardoso de Matos
  • Grazielle Vilas Bôas Huguenin



cocoa, chocolate, polyphenols, hypertension, inflammation


Hypertension has affected 1,13 billion people worldwide and is one of the main risk factors for cardiovascular disease, which has a high mortality rate. The aim of the study was to review the effect of cocoa on systolic and diastolic blood pressure in hypertensive patients, and its alterations in endothelial function and inflammation. We searched PubMed, Scopus, Science Direct, Lilacs and MedLine databases in August 2018. Inclusion criteria were limited to hypertensive individuals, cardiovascular diseases, intervention and randomized clinical studies; published since 2000 and in English, Spanish and Portuguese languages. A total of 433 articles were found in the search, which 13 met the inclusion criteria. The trials had a sample of 19 to 122 participants. The cocoa was offeredas chocolate bars and cocoa beverage. Chocolate bars doses ranged from 6 g to 100 g/ day and cocoa powder doses ranged from 5 g to 31 g/ day. Intervention ranged from 2 to 18 weeks. The results observed revealed a significant blood pressure-reducing effect of cocoa, an increase in flow-mediated dilation in the evaluation of endothelial function, and no changes in antioxidant and anti-inflammatory capacity were observed after intervention. The conclusion suggests that cocoa has a blood pressure lowering effect, but new studies are still required with hypertensive individuals so that their mechanisms are better evaluates and their efficacy proven.


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How to Cite

de Souza, C. A. R., de Souza, G. C., Miguel, T. de S., Pinho Junior, J. da S., de Matos , A. C., & Huguenin, G. V. B. (2023). Cocoa effects on blood pressure, endothelial function, and inflammation: a systematic review. Brazilian Journal of Health Review, 6(6), 27095–27113.



Original Papers