Long-term cocoa extract supplementation has null effect on hypertension risk in older adults

Taking cocoa extract supplements does not lower the risk of incident hypertension in older adults. However, it does seem to reduce the risk among those who have a normal systolic blood pressure (BP) at baseline, according to data from the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS).

COSMOS was a two-by-two factorial, double-blind, placebo-controlled randomized clinical trial that tested a cocoa extract supplement (two capsules containing 500 mg cocoa flavanols, with 80 mg [–]-epicatechin) and a multivitamin supplement.

The study population consisted of 21,442 women aged ≥65 years and men aged ≥60 years (mean age 71.1 years, 59 percent female). Of these participants, 8,905 who were free from hypertension at baseline were included in the analysis.

Over a median follow-up of 3.4 years, cocoa extract supplementation showed no significant effect on the risk of hypertension compared with placebo, with incidence rates of 7.1 vs 7.4 per 100 person-years, respectively (hazard ratio [HR], 0.96, 95 percent confidence interval [CI], 0.88–1.05).

Further analyses showed a reduced risk of hypertension with cocoa extract supplementation vs placebo in the subgroup of participants with baseline systolic BP <120 mm Hg (HR, 0.76, 95 percent CI, 0.64–0.90) but not in the subgroup of those with systolic BP of 120–139 mm Hg (HR, 1.05, 95 percent CI 0.93–1.18; p=0.002 for interaction). This beneficial effect became evident at year 2 after randomization.