Can cacao raise your blood pressure? The truth about flavonoids and heart health

January 1, 2026 •

3 min read

Epidemiological studies of the Kuna Indians in Central America, who consume large amounts of flavonoid-rich cocoa, show a surprisingly low incidence of hypertension. These findings highlight the cardiovascular benefits of cacao, suggesting that it can actually lower blood pressure, rather than raise it.

Quick Summary

This article examines the science behind cacao's effect on blood pressure, exploring how its flavanols promote vasodilation and outlining the differences between cacao and cocoa. It also addresses the potential impact of ingredients like caffeine and sugar on cardiovascular health.

Key Points

Cacao Lowers Blood Pressure: High-flavanol cacao promotes vasodilation by increasing nitric oxide production, which helps relax blood vessels and lower blood pressure.
Processing Matters: Minimally processed raw cacao has the highest concentration of beneficial flavanols, whereas alkalization (Dutching) and roasting significantly reduce this content.
Choose High-Cacao Dark Chocolate: To maximize benefits, opt for dark chocolate with at least 70% cacao content and consume in moderation to limit sugar intake.
Stimulants are Counterbalanced: While cacao contains the stimulants theobromine and some caffeine, the vasodilatory effects of its flavanols generally counteract any potential pressor effects.
Beware of Added Sugar and Fat: The sugar and unhealthy fats in processed chocolate can negate cacao's positive heart health effects, and in excess, can raise blood pressure.
Effects are Modest: The blood-pressure-lowering effect is small but meaningful, especially for individuals with pre-existing high blood pressure, and is best achieved with consistent intake.

Understanding the Cardiovascular Effects of Cacao

For many years, the health benefits of the cacao bean, from which chocolate is made, have been a subject of great interest. Research consistently shows that far from increasing blood pressure, the potent flavonoids in high-quality cacao can actually help lower it, especially in individuals with elevated blood pressure. This beneficial effect is tied to improved vascular function and nitric oxide production within the body. The question of whether cacao raise your blood pressure stems from misconceptions about stimulants and added ingredients commonly found in processed chocolate products.

The Role of Flavanols and Nitric Oxide

The primary mechanism behind cacao’s blood-pressure-lowering effect is its high concentration of flavanols, particularly epicatechin. These antioxidants stimulate the endothelium, the inner lining of blood vessels, to produce nitric oxide (NO). Nitric oxide is a powerful vasodilator, meaning it causes the blood vessels to relax and widen. This increased vasodilation leads to improved blood flow and reduced blood pressure. Studies have shown that consuming flavanol-rich cocoa products for as little as two weeks can produce a small but statistically significant reduction in blood pressure.

Key Actions of Cacao Flavanols:

Enhance Nitric Oxide Availability: Promote the synthesis and bioavailability of nitric oxide, which signals arteries to relax.
Improve Endothelial Function: Support the health of the blood vessel lining, improving vascular reactivity and blood flow.
Inhibit Platelet Aggregation: Help reduce the stickiness of platelets, a factor in clot formation.
Provide Antioxidant Effects: Scavenge free radicals, which can contribute to oxidative stress and inflammation in the cardiovascular system.

Factors That Influence Cacao's Effects

The effect of cacao on blood pressure is not a simple yes-or-no answer; it depends on several factors, including the type and amount of cacao consumed, and the individual's existing health conditions. Here is a comparison highlighting key differences:


Feature	High-Flavanol Cacao Powder/Nibs	Processed Milk Chocolate	High-Flavanol Dark Chocolate	Cacao-Rich Dietary Supplement
Processing	Minimally processed (raw or low heat)	Highly processed (roasted, often alkalized)	Variable processing; roasting reduces flavanols	Standardized for high flavanol content
Flavanol Content	Very high	Low or negligible	High (70% or more)	Guaranteed dose per serving
Sugar Content	None	High	Lower than milk chocolate	None or low
Fat Content	Low (cacao powder)	High	Variable, often high	Low (extracts, capsules)
Impact on BP	Net lowering effect due to flavanols	Potential to raise BP due to high sugar/fat	Can lower BP, but portion size matters	Consistent, measurable lowering effect

Theobromine and Caffeine

Cacao contains two key stimulants: theobromine and caffeine. Theobromine, a milder stimulant than caffeine, primarily acts as a vasodilator and cardiac stimulant, promoting a heart-healthier response than the vasoconstrictive effect of some stimulants. While caffeine can temporarily increase blood pressure, the amount in dark chocolate (especially in moderate servings) is relatively low compared to coffee and is generally outweighed by the vasodilating effects of the flavanols. However, excessive consumption of any chocolate product, particularly those high in sugar and caffeine, could potentially counteract the cardiovascular benefits.

The Negative Effects of Sugar and Processed Ingredients

Most conventional chocolate products, including milk chocolate and heavily processed dark chocolate, contain significant amounts of added sugar, milk, and unhealthy fats. High sugar intake is a known risk factor for elevated blood pressure and weight gain, which can increase the risk of heart disease. The process of alkalization, or “Dutching,” which reduces the bitterness of cocoa, can also destroy up to 80% of its beneficial flavanols. To reap the cardiovascular benefits, it's crucial to choose minimally processed cacao powder or dark chocolate with a high cacao percentage (70% or more) and to consume it in moderation.

Conclusion

The notion that cacao raises your blood pressure is a misconception, likely conflating raw cacao's effects with those of highly processed, sugar-laden chocolate products. The scientific evidence strongly indicates that the flavanols in high-quality cacao actually promote vasodilation and can contribute to a small but statistically significant reduction in blood pressure. However, the overall impact on cardiovascular health is moderated by the product's processing, its flavanol content, and other ingredients like sugar. For optimal heart-healthy benefits, consumers should opt for high-percentage dark chocolate or raw cacao powder and enjoy them as part of a balanced diet, consulting with a healthcare provider for any significant health concerns.

Learn more about the heart-healthy effects of flavonoids in the cardiovascular system.

Frequently Asked Questions

Raw cacao powder or nibs are minimally processed and contain the highest concentration of flavanols, the compounds responsible for the blood-pressure-lowering effect. High-cacao dark chocolate (70% or more) also offers benefits, but raw cacao is often the more potent choice with less added sugar.

Yes, processed milk chocolate often contains high levels of added sugar and unhealthy fats, which can contribute to high blood pressure and other cardiovascular risk factors. The beneficial flavanol content is also much lower compared to dark chocolate.

While studies vary, some suggest a daily intake of high-flavanol cocoa, such as a serving of high-cacao dark chocolate (around 6-25 grams) or a couple of tablespoons of cacao powder, may be effective. Consistency is key to achieving a noticeable, albeit small, effect.

The small amount of caffeine found in cacao can temporarily and slightly raise blood pressure. However, this effect is generally outweighed by the powerful vasodilating properties of the flavanols, especially when consumed in moderation.

Some studies suggest that flavanol-rich cocoa can cause a decrease in blood pressure within a few hours of consumption. The effects are most notable with consistent, long-term consumption rather than a single dose.

For individuals with elevated blood pressure, consuming moderate amounts of high-flavanol cacao is generally considered safe and potentially beneficial. However, you should always consult with a doctor before making significant dietary changes, especially if you are on medication.

While there is no known direct negative interaction with most blood pressure medications, cacao may enhance the antihypertensive effects. It is always wise to speak with a healthcare provider before incorporating large amounts of cacao into your diet, especially if taking prescribed medication.