ENDOTHELIAL DYSFUNCTION
Acute Consumption of Flavanol-Rich Cocoa and the Reversal of Endothelial Dysfunction in Smokers
Christian Heiss, MD, PhD*, ,
Petra Kleinbongard, PhD,
Andrè Dejam, MD, PhD,
Sandra Perré, MS,
Hagen Schroeter, PhD ,
Helmut Sies, MD, PhD* and
Malte Kelm, MD,*
* Institute for Biochemistry and Molecular Biology I
Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich-Heine-University, Duesseldorf, Germany
Department of Nutrition, University of California, Davis, California.
Manuscript received December 1, 2004;
revised manuscript received June 3, 2005,
accepted June 6, 2005.
* Reprint requests and correspondence: Dr. Malte Kelm, Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany (Email: kelm{at}uni-duesseldorf.de).
OBJECTIVES: This study was designed to assess the effect of flavanol-rich food on the circulating pool of bioactive nitric oxide (NO) and endothelial dysfunction in smokers.
BACKGROUND: Studies suggest that smoking-related vascular disease is caused by impaired NO synthesis and that diets rich in flavanols can increase bioactive NO in plasma.
METHODS: In smokers (n = 11), the effects of flavanol-rich cocoa on circulating NO species in plasma (RXNO) measured by reductive gas-phase chemiluminescence and endothelial function as assessed by flow-mediated dilation (FMD) were characterized in a dose-finding study orally administering cocoa containing 88 to 370 mg flavanols and in a randomized double-blind crossover study using 100 ml cocoa drink with high (176 to 185 mg) or low (<11 mg) flavanol content on two separate days. In addition to cocoa drink, ascorbic acid and NO-synthase inhibitor L-NMMA (n = 4) were applied.
RESULTS: There were significant increases in RXNO (21 ± 3 nmol/l to 29 ± 5 nmol/l) and FMD (4.5 ± 0.8% to 6.9 ± 0.9%, each p < 0.05) at 2 h after ingestion of 176 to 185 mg flavanols, a dose potentially exerting maximal effects. These changes correlated with increases in flavanol metabolites. Cocoa-associated increases in RXNO and FMD were reversed by L-NMMA. Ascorbic acid had no effect.
CONCLUSIONS: The circulating pool of bioactive NO and endothelium-dependent vasodilation is acutely increased in smokers following the oral ingestion of a flavanol-rich cocoa drink. The increase in circulating NO pool may contribute to beneficial vascular health effects of flavanol-rich food.
|
Abbreviations and Acronyms
| | FMD = flow-mediated dilation | | GTN = glycerol trinitrate | | HFCD = high-flavanol cocoa drink | | LFCD = low-flavanol cocoa drink | | NOS = nitric oxide synthase | | RXNO = sum of circulating NO species |
|
This article has been cited by other articles:
|
|
|
|
 
R. Corti, A. J. Flammer, N. K. Hollenberg, and T. F. Luscher
Cocoa and Cardiovascular Health
Circulation,
March 17, 2009;
119(10):
1433 - 1441.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-H. Chan, K.-K. Lau, K.-H. Yiu, S.-W. Li, H.-T. Chan, D. Y.-T. Fong, S. Tam, C.-P. Lau, and H.-F. Tse
Reduction of C-reactive protein with isoflavone supplement reverses endothelial dysfunction in patients with ischaemic stroke
Eur. Heart J.,
November 2, 2008;
29(22):
2800 - 2807.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Grassi, G. Desideri, S. Necozione, C. Lippi, R. Casale, G. Properzi, J. B. Blumberg, and C. Ferri
Blood Pressure Is Reduced and Insulin Sensitivity Increased in Glucose-Intolerant, Hypertensive Subjects after 15 Days of Consuming High-Polyphenol Dark Chocolate
J. Nutr.,
September 1, 2008;
138(9):
1671 - 1676.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Balzer, T. Rassaf, C. Heiss, P. Kleinbongard, T. Lauer, M. Merx, N. Heussen, H. B. Gross, C. L. Keen, H. Schroeter, et al.
Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial.
J. Am. Coll. Cardiol.,
June 3, 2008;
51(22):
2141 - 2149.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Campia and J. A. Panza
Flavanol-rich cocoa a promising new dietary intervention to reduce cardiovascular risk in type 2 diabetes?
J. Am. Coll. Cardiol.,
June 3, 2008;
51(22):
2150 - 2152.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Heiss, N. Amabile, A. C. Lee, W. M. Real, S. F. Schick, D. Lao, M. L. Wong, S. Jahn, F. S. Angeli, P. Minasi, et al.
Brief Secondhand Smoke Exposure Depresses Endothelial Progenitor Cells Activity and Endothelial Function: Sustained Vascular Injury and Blunted Nitric Oxide Production
J. Am. Coll. Cardiol.,
May 6, 2008;
51(18):
1760 - 1771.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. R. Allen, L. Carson, C. Kwik-Uribe, E. M. Evans, and J. W. Erdman Jr
Daily Consumption of a Dark Chocolate Containing Flavanols and Added Sterol Esters Affects Cardiovascular Risk Factors in a Normotensive Population with Elevated Cholesterol
J. Nutr.,
April 1, 2008;
138(4):
725 - 731.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Heiss, R. E. Sievers, N. Amabile, T. Y. Momma, Q. Chen, S. Natarajan, Y. Yeghiazarians, and M. L. Springer
In vivo measurement of flow-mediated vasodilation in living rats using high-resolution ultrasound
Am J Physiol Heart Circ Physiol,
February 1, 2008;
294(2):
H1086 - H1093.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Shenouda and J. A. Vita
Effects of Flavonoid-Containing Beverages and EGCG on Endothelial Function
J. Am. Coll. Nutr.,
August 1, 2007;
26(4):
366S - 372S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. E. Mann, D. J. Rowlands, F. Y.L. Li, P. de Winter, and R. C.M. Siow
Activation of endothelial nitric oxide synthase by dietary isoflavones: Role of NO in Nrf2-mediated antioxidant gene expression
Cardiovasc Res,
July 15, 2007;
75(2):
261 - 274.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. van Praag, M. J. Lucero, G. W. Yeo, K. Stecker, N. Heivand, C. Zhao, E. Yip, M. Afanador, H. Schroeter, J. Hammerstone, et al.
Plant-Derived Flavanol (-)Epicatechin Enhances Angiogenesis and Retention of Spatial Memory in Mice
J. Neurosci.,
May 30, 2007;
27(22):
5869 - 5878.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Shapiro, P. Singer, Z. Halpern, and R. Bruck
Polyphenols in the treatment of inflammatory bowel disease and acute pancreatitis
Gut,
March 1, 2007;
56(3):
426 - 436.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Alspach
THE TRUTH IS OFTEN BITTERSWEET...: CHOCOLATE DOES A HEART GOOD
Crit. Care Nurse,
February 1, 2007;
27(1):
11 - 15.
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Heinrich, K. Neukam, H. Tronnier, H. Sies, and W. Stahl
Long-Term Ingestion of High Flavanol Cocoa Provides Photoprotection against UV-Induced Erythema and Improves Skin Condition in Women
J. Nutr.,
June 1, 2006;
136(6):
1565 - 1569.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Schroeter, C. Heiss, J. Balzer, P. Kleinbongard, C. L. Keen, N. K. Hollenberg, H. Sies, C. Kwik-Uribe, H. H. Schmitz, and M. Kelm
(-)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans
PNAS,
January 24, 2006;
103(4):
1024 - 1029.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, D. Sahn, and S. Tsimikas
Highlights of the Year in JACC 2005
J. Am. Coll. Cardiol.,
January 3, 2006;
47(1):
184 - 202.
[Full Text]
[PDF]
|
|
|
|
