Table 4

Study design, participants, follow-up and outcomes for studies evaluating chocolate consumption and CVD

Study IDDietary exposuresStudy designNo in analysisCharacteristicsFollow-up (years)Outcome measuresMeasures of association
Buijsse et al5Cocoa intakeProspective cohort, Netherlands470White men with mean age 72 years15Cardiovascular mortality at 15 yearsRR: 0.50 (0.32–0.78) for >2.25 g/day vs <0.5 g/day (top vs bottom tertile)
Buijsse et al20Chocolate consumptionProspective cohort, Germany19 357Men and women with mean age of 49 years, 38% were men with no history of myocardial infarction and stroke and not using blood pressure drugs10Incident MI, stroke and composite of both at mean of 8.1 years follow-upRR: MI 0.73 (0.47–1.18), stroke 0.52 (0.30–0.89), composite 0.61 (0.44–0.87) for 4th quartile vs 1st quartile energy-adjusted chocolate consumption
Djousse et al19Chocolate consumptionCross-sectional, USA4970Men and women with mean age of 52 years (range 25–93 years), 45% were men and 5% were of African-American originNAPrevalent coronary heart disease (MI or coronary revascularisation)OR: 0.43 (0.27–0.68) for >5 times a week vs no consumption (based on some degree of post-hoc categorisation of collected data).
Janszky et al21Chocolate consumptionProspective cohort, Sweden1169Men (71%) and women who survived an acute myocardial infarction with mean age of 59 years8Cardiovascular mortality, recurrent MI, stroke and congestive heart failureHR: Cardiovascular mortality 0.34 (0.17–0.70), recurrent MI 0.86 (0.54–1.37), stroke 0.62 (0.33–1.16) for <2× week vs never (based on some degree of post-hoc categorisation of collected data)
Larsson et al6Chocolate consumptionProspective cohort, Sweden33 372Women with no history of stroke, age range 49–83 years10.4Incident strokeRR: 0.80 (0.66–0.99) >45 g/week vs <8.9 g/week (top vs bottom quartile)
Larsson et al7Chocolate consumptionProspective cohort, Sweden37 103Men with mean age mean of 59 years and no history of stroke10.2Incident strokeRR: 0.83 (0.70–0.99) for >51.6 g/week vs <12 g/week (top vs bottom quartile)
Lewis et al8Chocolate consumptionPost-hoc analysis of a randomised trial of calcium supplementation in women, Australia1216Women, mean age 75 years9.5Atherosclerotic vascular disease and ischaemic heart diseaseHR: Ischaemic heart disease 0.65 (0.46–0.94) for <1 serving/week vs >1 serving/week (based on some degree of post-hoc categorisation of collected data)
Mink et al9Chocolate consumptionProspective cohort, USA34 489Women with mean age 62 years with no history of heart disease16CHD mortality and stroke mortalityRate ratio: CHD mortality 0.98 (0.88–1.10), stroke mortality 0.85 (0.70–1.03) for <1 per week vs >1 per week (based on some degree of post-hoc categorisation of collected data)
Current studyChocolate consumptionCohort25 66355% women, 99.6% white Caucasians, mean age 59 years with no history of heart disease or stroke11.8Incident CHD, stroke and composite of the two, defined as CVDHR: CHD 0.88 (0.77–1.01), stroke 0.77 (0.62–0.96), CVD 0.86 (0.76–0.97) (top quintile vs bottom quintile)
  • CHD, coronary heart disease; CVD, cardiovascular disease; MI, myocardial infarction.