Dark chocolate helps prevent CV events

Dark chocolate helps prevent CV events
Dark chocolate helps prevent CV events

HealthDay News -- Eating a moderate amount of dark chocolate daily may offer a long-term, cost-effective way to reduce cardiovascular events in patients at risk for heart disease.

Consuming dark chocolate every day could help patients with metabolic syndrome reduce the number of cardiovascular events they experience by 85 per 10,000 population in a 10-year period, Chris Reid, PhD, of Monash University in Melbourne, and colleagues determined using a modeling study.

The therapy also meets cost-effectiveness criteria, costing an average $42 per year for an incremental cost-effectiveness ratio (ICER) of $50,000 per years of life saved.

"Evidence to date suggests that the chocolate would need to be dark and of at least 60% to 70% cocoa, or formulated to be enriched with polyphenols," the researchers reported online in BMJ.

Data from several recent studies suggest that eating dark chocolate can help lower BP and lipid levels, so Reid and colleagues looked at data from patients in the Australian Diabetes, Obesity, and Lifestyle study to determine its effectiveness and cost as a therapy to reduce cardiovascular events in those at risk.

They used a Markov model to assess the health effects and associated costs of daily consumption of plain dark chocolate compared with no chocolate in a population of individuals with metabolic syndrome but without diabetes or cardiovascular disease. 

The treatment effects associated with dark chocolate consumption elicited from published meta-analyses were used to determine the absolute number of cardiovascular events with and without treatment. The costs associated with these events and treatments were examined.

The final model included a total of 2,013 patients with metabolic syndrome, mean age 53.6, mean systolic blood pressure 141.1 mmHg, mean total cholesterol 6.1 mmol/L, mean HbA1c 34.4 mmol/mol, and mean waist circumference 100.4 cm.

Over 10 years the researchers determined that daily consumption of dark chocolate with a polyphenol content equivalent to 100 g of dark chocolate was associated with a reduction of 85 cardiovascular events per 10,000 population treated in a 10-year time frame. Assuming 100% compliance, this would equate to 70 non-fatal and 15 fatal cardiovascular events prevented per 10,000 population during that time period.

If compliance were lowered to 90%, the number of preventable non-fatal and fatal events would fall to 60 and 10, respectively, and at 80% compliance to 55 and 10, respectively. Even at these levels, dark chocolate consumption is still an effective and cost-effective intervention strategy, the researchers noted.

They added that chocolate has the additional benefit of "being by and large a pleasant, and hence sustainable, treatment option."

Study limitations included reliance on the Framingham algorithm, which may underestimate risk in a high-risk population, and the assumption that the cardiovascular benefits of chocolate consumption -- which have only been observed in short term trials thus far -- extend to 10 years.

Zomer E et al. BMJ. 2012; doi:10.1136/bmj.e3657.
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