Cocoa products are rich in chemical compounds called have attracted interest as they might help to reduce blood pressure, a known risk factor for cardiovascular disease (disorders of the heart and blood vessels). The blood properties are thought to be related to the widening of the blood vessels, caused by nitric oxide mostly between two and12 weeks, with only one of 18 weeks. The studies involved 1804 mainly healthy adults. They provided participants with 30 to 1218 mg of (average of 670 mg) in 1.4 to 105 grams of cocoa products per day in the active intervention group. Seven of the studies were funded by companies with a commercial interest in their results, and the reported effect was slightly larger in these studies, indicating possible bias. The evidence is current to November 2016. 40 treatment comparisons revealed a small but statistically significant lowering of blood pressure (systolic and diastolic) of 1.8 mmHg. This small reduction in blood pressure might complement other treatment options and might contribute to reducing the risk of cardiovascular disease whether participants' blood pressure at the start of the study, their age, an awareness of group allocation (active or control), the content used in the control group or how long the study lasted may explain variations between trials. While blood pressure status (high blood pressure or normal blood pressure) is a likely factor in the effect size of cocoa on blood pressure, the impact of other factors needs to be confirmed or rejected in further trials effects including digestive complaints and dislike of the trial product were reported by only 1% of people in the active cocoa intervention group and 0.4% of people in the control groups to establish whether regularly eating cocoa products has a beneficial effect on blood pressure and cardiovascular health over and whether there are any side effects of the use of cocoa products on a daily basis of moderate quality. We were unable to identify any randomized controlled trials that tested the effect of daily use of cocoa products on blood pressure, and there were no trials that measured the health consequences of high blood pressure, such as heart attacks or strokes cocoa products are rich in chemical compounds that have attracted interest as they might help to reduce blood pressure, a known risk factor for cardiovascular disease (disorders of the heart and blood vessels). The blood properties are thought to be related to the widening of the blood vessels, caused by nitric oxide. Study characteristics studies were short, mostly between two and12 weeks, with only one of 18 weeks. The studies involved 1804 mainly healthy adults. They provided participants with 30 to 1218 mg of (average of 670 mg) in 1.4 to 105 grams of cocoa products per day in the active intervention group. Seven of the studies were funded by companies with a commercial interest in their results, and the reported effect was slightly larger in these studies, indicating possible bias. The evidence is current to November 2016. Key of 40 treatment comparisons revealed a small but statistically significant lowering of blood pressure (systolic and diastolic) of 1.8 mmHg. This small reduction in blood pressure might complement other treatment options and might contribute to reducing the risk of cardiovascular disease. We investigated whether participants' blood pressure at the start of the study, their age, awareness of group allocation (active or control), the content used in the control group how long the study lasted may explain variations between trials. While blood pressure status (high blood pressure or normal blood pressure) is a likely factor in the effect size of cocoa on blood pressure, the impact of other factors needs to be confirmed or rejected in further trials. Side effects including digestive complaints and dislike of the trial product were reported by only 1% of people in the active cocoa intervention group and 0.4% of people in the control groups to establish whether regularly eating cocoa products has a beneficial effect on blood pressure and cardiovascular and whether there are any side effects of the use of cocoa products on a daily basis. Quality of evidence is of moderate quality. We were unable to identify any randomized controlled trials that tested the effect of daily use of cocoa products on blood pressure, and there were no trials that measured the health consequences of high blood pressure, such as heart attacks or strokes.
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