Dataset Information

Using digital health technology to evaluate the impact of chocolate on blood pressure: Results from the COCOA-BP study.

ABSTRACT:

Background

High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD). Consumption of dark chocolate, which is high in flavonoids that may reduce CVD risk, is an attractive intervention to reduce to BP. Additionally, the use of mobile health (mHealth) technologies (eg, telehealth, smartphones, and wearable devices) can improve outcomes in patients with CVD.

Objective

The purpose of this study was to investigate the impact of dark chocolate intake on BP, subject use of mHealth, and integration of mHealth into a clinical trial.

Methods

The COCOA-BP (ChOcolate COnsumption And Blood Pressure) study was a prospective, single-center, pre-/postintervention study that enrolled 62 healthy volunteers. The study consisted of 3 phases: smartwatch/smart BP monitor familiarization and washout from chocolate (week 1); control (week 2); and intervention (weeks 3 and 4). During the intervention phase, subjects consumed 50 g of dark chocolate per day. The primary endpoint was change in resting systolic BP between the intervention and control phases. Additional endpoints included device accuracy and correlation with physical activity.

Results

Mean resting systolic BP was 116.4 mm Hg before chocolate intake among 62 participants (mean age 37 years; 61% female). After chocolate intake, mean resting systolic BP was 116.0 mm Hg (difference -0.4; P = .69). These findings suggest that 2 weeks of dark chocolate intake did not reduce resting systolic BP. There was poor agreement between mHealth device and standard (nurse-performed) measurements.

Conclusion

In this study, short-term dark chocolate intake did not seem to reduce BP. mHealth technology shows great potential for use in clinical studies, but challenges related to device accuracy and compliance need to be addressed.

SUBMITTER: Christen T

PROVIDER: S-EPMC8890357 | biostudies-literature | 2020 Sep-Oct

REPOSITORIES: biostudies-literature

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Publications

Using digital health technology to evaluate the impact of chocolate on blood pressure: Results from the COCOA-BP study.

Christen Thomas T Nagale Sandra S Reinitz Steve S Narayanan Shruthi S Roy Kristine K Allocco Dominic J DJ Osattin Alison A

Cardiovascular digital health journal 20200901 2

<h4>Background</h4>High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD). Consumption of dark chocolate, which is high in flavonoids that may reduce CVD risk, is an attractive intervention to reduce to BP. Additionally, the use of mobile health (mHealth) technologies (eg, telehealth, smartphones, and wearable devices) can improve outcomes in patients with CVD.<h4>Objective</h4>The purpose of this study was to investigate the impact of dark chocolate intake on BP, subje ...[more]

PMID: 35265879

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Project description:ObjectiveThere is rising interest in digital health in preventive cardiology, particularly for blood pressure (BP) management. In a digital health study of early BP assessment following acute myocardial infarction (AMI), we sought to examine feasibility and the (1) proportion of post-AMI patients with controlled BP and hypotension, and (2) association between prior cardiovascular disease (CVD) and BP post-AMI.MethodsIn this substudy of the parent Myocardial infarction, COmbined-device, Recovery Enhancement (MiCORE) study, type 1 AMI patients were enrolled between October 2017 and April 2019. Participants self-monitored their BP through 30 days after hospital discharge using an FDA-approved wireless BP monitor connected with a smartphone application. Linear mixed-effects models assessed the association between prior CVD and BP trajectory post-discharge, adjusting for antihypertensive medications and a propensity score inclusive of CVD risk factors.ResultsSixty-eight AMI patients (mean age 58 ± 10 years, 75% male, 68% white race, 68% history of hypertension, 24% prior CVD) provided 2638 measurements over 30 days. The percentage of BP control <130/80 mmHg was 59.6% (95% CI: 54.3-64.9%) and <140/90 mmHg was 83.7% (95% CI: 80.3-87.2%). The percentage of systolic BP <90 mmHg was 1.1% (95% CI: 0.17-2.0%) and the percentage of diastolic BP <60 mmHg was 3.9% (95% CI: 2.6-5.2%). Prior CVD was associated with 12.2 mmHg higher mean daily systolic BP during admission (95% CI: 3.5-20.9 mmHg), which persisted over follow-up. There was no association between prior CVD and diastolic BP.ConclusionThe digital health program was feasible and ~40% of post-AMI patients who engaged in it had uncontrolled BP according to recent guideline cutpoints, while hypotension occurred rarely. The gap in BP control was especially large in patients in whom AMI represented recurrent CVD. These data suggest an opportunity for more aggressive secondary prevention early after MI as care models integrate digital health.

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Dataset Information

Using digital health technology to evaluate the impact of chocolate on blood pressure: Results from the COCOA-BP study.

Background

Objective

Methods

Results

Conclusion

Publications

Using digital health technology to evaluate the impact of chocolate on blood pressure: Results from the COCOA-BP study.

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