HypertensionMeta-analysis
Impact of flavan-3-ols on blood pressure and endothelial function in diverse populations: a systematic review and meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of randomised trials
- random-effects
- meta-regression
Authors' conclusion
Flavan-3-ol-rich foods considerably reduce elevated BP and improve endothelial function independent of blood pressure supporting their use for cardiovascular prevention.
Study context
- Population
- Diverse populations in randomized controlled trials (RCTs) of flavan-3-ol intake (published 1946–03/2024)145 RCTs in 109 publications
- Participants
- 5,205 participants
- Comparison
- Flavan-3-ol-rich interventions vs control
- Outcome
- BP and endothelial function (flow-mediated dilation)
Pooled result
As reported in the abstract
Office and 24 h ambulatory BP (SBP/DBP), chronic repetitive consumption
Office blood pressure (BP) change with flavan-3-ol interventions, mmHg
SBP/DBP −2.8 [95% CI −3.9, −1.7]/−2.0 [−2.6, −1.3] mmHg (95% CI)
24 h ambulatory BP change with flavan-3-ol interventions, mmHg
SBP/DBP −3.7 [−5.8, −1.6]/−2.6 [−4.5, −0.8] mmHg (95% CI)
Further pooled results
BP with elevated/hypertensive baseline BP or categorical hypertension (subgroup)
- Office BP change, mmHg (SBP/DBP)
- −5.9 [−10.0, −1.8]/−2.7 [−4.4, −1.0] mmHg
- 24 h ABP change, mmHg (SBP/DBP)
- −6.8 [−16.3, 2.8]/−5.1 [−12.5, 2.2] mmHg
Meta-regression of BP lowering
- BP lowering inversely related to baseline BP, not to proportion with CVD, DM or study duration; dose-dependent on epicatechin dose only in cocoa studies
Flow-mediated dilation
- Increase after acute consumption
- +2.0% [1.6, 2.3]
- Increase after repetitive consumption
- +1.7% [1.3, 2.2]
- independent of BP
Safety
Adverse events
- Reported adverse events minor and low
- 0.4%
Original publication
Impact of flavan-3-ols on blood pressure and endothelial function in diverse populations: a systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol. Published 24 March 2025. doi:10.1093/eurjpc/zwaf173
Summarised from the published abstract; every number is checked against it