Flavanols and Cardiovascular Disease Prevention

Christian Heiss; Carl L. Keen; Malte Kelm


Eur Heart J. 2010;31(21):2583-2592. 

In This Article

Regenerative Processes: Impact on Circulating Angiogenic Cells

Bone marrow-derived circulating angiogenic cells (CACs; also referred to as early endothelial progenitor cells[74]) may contribute to the recovery and maintenance of endothelial function.[75] Primary and secondary preventive lifestyle interventions and statin therapy can enhance endogenous endothelial repair mechanisms by stimulating CAC mobilization.[76] It has been reported that 2–4 weeks of flavanol-rich foods can mobilize EPCs in CAD patients, healthy smokers and non-smokers.[64,77,78] In a randomized double-blind study in patients with coronary artery disease a cocoa–flavanol intervention (30 days)-related increase in FMD and decrease in blood pressure was paralleled by a significant increase in CD34/KDR and CD133/KDR-CACs.[64] Similarly, in healthy smokers, green tea (8 g/day) ingestion (one armed study) over 2 weeks led to a significant increase in FMD and EPCs. Interestingly, a smaller amount of this green tea (5 g/day) over 4 weeks failed to increase EPCs in haemodialysis patients despite significantly increased FMD.[55] Huang et al.[77] showed that 3 weeks of 300 ml red wine consumption in healthy subjects led to a significantly higher number of EPCs that was paralleled by increased FMD response, NOX levels, and decreased asymmetrical dimethylarginine (ADMA), an endogenous inhibitor of NOS, however, other alcohol-containing drinks (beer and vodka) were used as controls, prohibiting proper blinding.


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