Vienna, Austria, Thursday 15 April: Doctors could soon be prescribing a dose of dark chocolate to help patients suffering from liver cirrhosis and from dangerously high blood pressure in their abdomen, according to new research presented today at the International Liver CongressTM 2010, the Annual Meeting of the European Association for the Study of Liver in Vienna, Austria.
According to the Spanish research, eating dark chocolate reduces damage to the blood vessels of cirrhotic patients and also lowers blood pressure in the liver. Dark chocolate contains potent anti-oxidants which reduce the post-prandial (after-meal) blood pressure in the liver (or portal hypertension) associated with damaged liver blood vessels (endothelial dysfunction). The data also showed that eating dark chocolate may exert additional beneficial effects throughout the whole body. In comparison, white chocolate, which contains no beneficial 'phytochemicals', did not result in the same effects.
Professor Mark Thursz, MD FRCP, Vice Secretary of EASL and Professor of Hepatology, at Imperial College London said: "As well as advanced technologies and high science, it is important to explore the potential of alternative sources which can contribute to the overall wellbeing of a patient. This study shows a clear association between eating dark chocolate and portal hypertension and demonstrates the potential importance of improvements in the management of cirrhotic patients, to minimise the onset and impact of end stage liver disease and its associated mortality risks".
Cirrhosis is scarring of the liver as a result of long-term, continuous damage to the liver . In cirrhosis, circulation in the liver is damaged by oxidative stress and reduced antioxidant systems. After eating, blood pressure in the abdominal veins usually increases due to increased blood flow to the liver.
This is particularly dangerous and damaging to cirrhotic patients as they already have increased blood pressure in the liver (portal hypertension) and elsewhere which, if severe, can cause blood vessel rupture. Thus, eating dark chocolate may ultimately prevent this potential threat to cirrhotic patients.
In this study 21 cirrhotic patients with end stage liver disease (child score 6.9±1.8;MELD 11±4; hepatic venous pressure gradient (HPVG*)16.6±3.8mmHg) were randomised to receive a standard liquid meal. Ten patients received the liquid meal containing dark chocolate (containing 85% cocoa, 0.55g of dark chocolate/Kg of body weight) while 11 patients received the liquid meal containing white chocolate which is devoid of cocoa flavonoids (anti-oxidant properties) according to body weight. HVPG, arterial pressure and portal blood flow (PBF)** were measured at baseline and 30 minutes after meal administration, using a US-Doppler.
Both meals caused a highly significant but similar increase in portal blood flow with a +24% increase in dark chocolate compared to +34% in those patients who received white chocolate. Interestingly, post-prandial hyperaemia*** was accompanied by an increase in HVPG resulting in a statistically significant increase (17.3±3.6mmHg to 19.1±2.6mmHg, p=0.07) for those patients eating dark chocolate and those receiving white chocolate (16.0±4.7mmHg to 19.7±4.1mmHg, p=0.003). Post-prandial increase in HVPG was markedly reduced in patients receiving dark chocolate (+10.3±16.3% Vs +26.3±12.7%, p=0.02).
*HVPG is blood pressure in the liver
**PBF refers to blood flow in the liver
***Hyperaemia refers to increase blood flow to tissues
EASL is the leading European scientific society involved in promoting research and education in hepatology. EASL attracts the foremost hepatology experts as members and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European Liver policy.
EASL's work continues throughout the year with numerous events and initiatives, including:
About The International Liver CongressTM 2010
The International Liver Congress™ 2010, the 45th annual meeting of the European Association for the study of the Liver, is being held at the Reed Messe Wien congress center, Vienna, Austria from April 14th-18th, 2010. The congress annually attracts over 7,500 clinicians and scientists from around the world and provides an opportunity to hear the latest research, perspectives and treatments of liver disease from principal experts in the field.
1De Gottardi A. et al, Dark Chocolate attenuates the post –prandial increase in HVPG in patients with cirrhosis and portal hypertension. Abstract presented at The International Liver CongressTM 2010
2Cirrhosis Overview. NHS Choices. September 2009. http://www.nhs.uk/Conditions/Cirrhosis/Pages/Introduction.aspx accessed 19.03.10
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