黑巧克力提供心血管保护还需更多证据
2012-06-16 23:37:29   来源：37度医学网   作者：  评论：0 点击：

June 4, 2012 — The blood pressure–lowering and lipid effects of dark chocolate could be an effective — and money-saving — strategy for preventing cardiovascular events in high-risk patients, a new study suggests.
2012年6月4日——一项新的研究提示黑巧克力能有效降低血压和血脂水平，对于具有心血管病高危因素的患者是一种省钱的预防策略。
"The findings of this study suggest that the blood pressure lowering and lipid effects of plain dark chocolate could represent an effective and cost effective strategy for the prevention of cardiovascular disease in people with metabolic syndrome (and no diabetes)," the researchers, with senior author Christopher M. Reid, PhD, CCRE Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia, conclude.
澳大利亚、维多利亚、墨尔本Alfred 中心Monash 大学预防医学和流行病学系第一作者Christopher M. Reid, PhD,及其他研究者总结道：“这些发现提示黑巧克力能有效降低血压和血脂水平对有代谢综合征的患者（非糖尿病）而言是预防心血管疾病的有效和经济的策 略。”
"Chocolate benefits from being by and large a pleasant and, hence sustainable, treatment option," they write. "Evidence to date suggests that the chocolate would need to be dark and of at least 60-70% cocoa, or formulated to be enriched with polyphenols."
“巧克力的益处是能带来持久的愉悦，是一种治疗选择。证据提示只有黑巧克力或至少含60%至70%的可可或富含多酚的巧克力才有作用。”
Dark chocolate, derived from cocoa, is rich in polyphenols, specifically flavonoids that exhibit antihypertensive, anti-inflammatory, antithrombotic, and metabolic effects, all of which may contribute to cardio-protection.
从可可中提取而成的黑巧克力富含多酚，尤其是黄酮类具有抗高血压、抗炎、抗血栓及具有代谢作用，所有这些都具有心血管保护作用。
The study was published online May 31 in the BMJ.
该研究发表在BMJ5月31日的在线期刊上。
Long-Term Effects
长期效果
Previous studies have shown that dark chocolate consumption may lower blood pressure, but they have been relatively short, only up to a maximum of 18 weeks. Studies have also shown that dark chocolate may decrease total and low-density lipoprotein cholesterol and increase high-density lipoprotein cholesterol, but again, these changes have been explored only in short-term trials.
既往的研究已证实黑巧克力能降低血压但是这种作用维持时间短，最长也只有18周。研究同样证实黑巧乐力可以降低低密度脂蛋白和增高高密度脂蛋白，但是这些改变仅在短期研究中体现。
To determine potential long-term effects of consuming dark chocolate every day, as well as the cost-effectiveness of this strategy, Australian researchers used statistical modeling techniques, particularly a Markov model to which health states ("alive without cardiovascular disease," "alive with cardiovascular disease," "dead from cardiovascular disease," "dead from other causes") and decision analysis (no dark chocolate [control], or with dark chocolate [treatment]) were added.
为了确定每天进食黑巧 克力所带来的长期效果和这种干预策略的成本效益，澳大利亚研究者使用统计模型尤其是Markov模型来确定健康状态（没有心血管疾病、患有心血管疾病、死 于心血管疾病、死于其他疾病）和选择分析（未食用黑巧克力（对照组）、食用黑巧克力（治疗组））之间的关系。
With each annual cycle, the researchers used risk prediction algorithms and population life tables to estimate how eating dark chocolate every day for 10 years would affect patients with metabolic syndrome.
在一年中，研究者们使用风险预测公式和人群生命表格来估计在十年间每天食用黑巧克力是如何影响具有代谢综合征的患者。
The study used data on 2013 participants from the Australian Diabetes Obesity and Lifestyles study who had metabolic syndrome, did not have a diagnosis of cardiovascular disease or frank diabetes, and who were not receiving antihypertensive medications.
该研究使用的数据来自澳大利亚糖尿病肥胖和生活方式研究中的2013名受试者，他们具有代谢综合征但是没有心血管疾病或糖尿病的诊断，也没有接受任何降压治疗。
The patients were relatively young (mean age, 53.6 years) and considered at high risk: They had a mean systolic blood pressure of 141.1 mmHg, mean total cholesterol level of 6.1 mmol/L, mean hemoglobin A1c of 34.4 mmol/mol, and mean waist circumference of 100.4 cm.
患者相对较年轻（平均年龄53.6岁），并且我们认为这些患者是高危人群：他们平均收缩压为141.1mmHg，平均总胆固醇水平6.1mmol/L,平均糖化血红蛋白水平34.4mmol/L,平均腰围是100.4cm。
The researchers concluded that under the best-case scenario, in which all these patients ate dark chocolate daily for a decade, 70 nonfatal cardiovascular events, including nonfatal stroke and nonfatal myocardial infarction per 10,000 population, as well as 15 cardiovascular related deaths per 10,000 population, could be prevented.
研究者们总结道：“在最好的情况下，所有这些患者每天都进食黑巧克力，持续了10年，每10000人中出现70例出现非致死性心血管事件（包括非致死性卒中和心梗），每10000人中出现15例心血管相关死亡事件。”
The estimated incremental cost-effectiveness ratio was $52,500 per years of life saved when $42 per person per year was assumed to have been spent on a prevention strategy using dark chocolate.
估计增加的成本效益比率是每年52500磅，42磅每人年进食黑巧克力作为预防策略。
Even if only 80% of individuals with metabolic syndrome adhered to daily consumption of dark chocolate over 10 years, preventing only 55 nonfatal and 10 fatal events per 10,000, it would still be considered an effective and cost-effective intervention strategy, the authors write.
在10年中虽然只有80%的代谢综合征个体每天进食黑巧克力，仅预防了55/10000非致死性事件和10/10000致死性事件，我们仍然认为这是有效和经济的预防策略。
Prevention Strategy
预防策略
A dark chocolate prevention strategy of $42 per person per year in a high-risk population would be cost-effective "based on the commonly accepted, albeit arbitrary, threshold of $50,000 per years of life saved," said the authors.
在高危人群中应用黑巧克力42磅每人年进行预防是符合经济效益的，平素的阈值50000磅每年。
The $42 per person per year could be devoted to advertising, education campaigns, or, potentially, subsidization of dark chocolate in this high-risk population, they said.
可在该高危人群中通过广告、教育运动或补助黑巧克力（42磅每人年）。
The authors point out that they did not assess the potential effectiveness of dark chocolate consumption on cardiovascular events other than nonfatal stroke and nonfatal myocardial infarction, such as heart failure.
作者们指出他们仅评价黑巧克力对心血管疾病的潜在效果而不是对于非致死性卒中或非致死性心梗或心衰的效果。
They also stressed that the effects of dark chocolate consumption on blood pressure and total cholesterol, although beneficial, are not as profound as those of drug interventions.

他们同时也强调进食黑巧克力对血压和总胆固醇的效果，虽然也存在有益作用但比不上药物干预的效果。