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Wine, alcohol and atherosclerosis: clinical evidences and mechanisms
1Unidade de Aterosclerose, Instituto do Coração, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brasil. daluzp@incor.usp.br
Insights
Moderate red wine consumption may decrease cardiac mortality from atherosclerosis, a chronic inflammatory disease. Flavonoids in red wine offer cardiovascular benefits, but excessive intake poses risks.
Area of Science:
- Cardiovascular Science
- Nutritional Epidemiology
- Molecular Biology
Background:
- Atherosclerosis is a leading cause of death globally, driven by risk factors like hypercholesterolemia and hypertension.
- Epidemiological studies suggest moderate alcohol, particularly red wine, intake is linked to reduced cardiac mortality.
- The "J curve" describes alcohol's effect: moderate drinkers benefit, while abstainers and heavy drinkers face higher risks.
Purpose of the Study:
- To explore the cardioprotective mechanisms of moderate red wine consumption in atherosclerosis.
- To investigate the role of flavonoids in mitigating atherosclerotic cardiovascular events.
- To compare the benefits of moderate red wine intake versus a flavonoid-rich diet.
Main Methods:
- Review of epidemiological studies on alcohol consumption and cardiac mortality.
- Analysis of experimental studies investigating the biological effects of wine components.
- Examination of proposed mechanisms, including antiplatelet, antioxidant, and endothelial function effects.
Main Results:
- Moderate red wine intake is associated with decreased cardiac mortality, potentially due to its flavonoid content.
- Flavonoids contribute to cardiovascular health through antiplatelet actions, increased HDL, antioxidation, and improved nitric oxide production.
- A diet rich in fruits and vegetables, also containing flavonoids, may offer even greater benefits.
Conclusions:
- Moderate red wine consumption, when free of contraindications, may benefit individuals at risk of atherosclerotic cardiovascular events.
- Flavonoids are key bioactive compounds in red wine responsible for observed cardioprotective effects.
- A flavonoid-rich diet, encompassing fruits and vegetables, presents a potentially more advantageous strategy for cardiovascular health.
Abstract:
Atherosclerosis is a chronic inflammatory disease which may cause obstructions of the coronary, cerebral and peripheral arteries. It is typically multifactorial, most often dependent on risk factors such as hypercholesterolemia, diabetes, smoking, hypertension, sedentarism, and obesity. It is the single main cause of death in most developed countries due to myocardial infarction, angina, sudden death, and heart failure. Several epidemiological studies suggest that moderate alcohol intake, especially red wine, decrease cardiac mortality due to atherosclerosis. The alcohol effect is described by a J curve, suggesting that moderate drinkers may benefit while abstainers and heavy drinkers are at higher risk. Experimental studies indicate that most beneficial effects of drinking are attributable to flavonoids that are present in red wine, purple grape juice and several fruits and vegetables. The mechanisms include antiplatelet actions, increases in high-density lipoprotein, antioxidation, reduced endothelin-1 production, and increased endothelial nitric oxide synthase expression which causes augmented nitric oxide production by endothelial cells. These findings lead to the concept that moderate red wine drinking, in the absence of contraindications, may be beneficial to patients who are at risk of atherosclerotic cardiovascular events. Moreover, a diet based on fruits and vegetables containing flavonoids may be even more beneficial.
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