Cocoa Extract Supplementation Does Not Reduce Hypertension Risk

THURSDAY, Aug. 28, 2025 (HealthDay News) — Long-term cocoa extract supplementation does not reduce the risk for incident hypertension but does reduce hypertension incidence among those with normal systolic blood pressure (BP) at baseline, according to a study published online Aug. 20 in Hypertension.

Rikuta Hamaya, M.D., from Brigham and Women”s Hospital and Harvard Medical School in Boston, and colleagues examined the role of cocoa flavonols on incident hypertension in a large-scale, long-term randomized clinical trial. A total of 21,442 women aged 65 years and older and men aged 60 years and older were randomly assigned to receive cocoa extract and a multivitamin or placebos, which did not include any bioactive compounds. The effect of cocoa extract on incident hypertension was examined in 8,905 participants free from baseline hypertension.

The researchers found that cocoa extract supplementation had no significant effect on incident hypertension in an intention-to-treat analysis during a median follow-up of 3.4 years, with incidence rates of 7.1 and 7.4 per 100 person-years in the cocoa and placebo groups, respectively (hazard ratio [HR], 0.96; 95 percent confidence interval [CI], 0.88 to 1.05). In subgroup analyses, the incidence of hypertension was reduced with cocoa extract supplementation among individuals with baseline systolic BP <120 mm Hg but not among those with systolic BP of 120 to 139 mm Hg (HR, 0.76 [95 percent CI, 0.64 to 0.90]; HR, 1.05 [95 percent CI, 0.93 to 1.18]). At year 2 after random assignment, the effect among those with baseline systolic BP <120 mm Hg became evident.

“This finding raises the hypothesis that cocoa flavanols may be more effective in preserving vascular health and preventing early blood pressure elevation, rather than lowering already-elevated blood pressure,” the authors write.

Two authors disclosed ties to Mars Edge and Pfizer.

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