The cardiovascular protective effect of red wine

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Twenty-six years ago, St Legar and colleagues 1 St Legar A.S. Moore F. Cochrane A.L. Factors associated with cardiomortality in developed countries with particular reference to consumption of wine. Lancet. 1979; 1 : 1017-1020 Abstract PubMed Scopus (599) Google Scholar first drew attention to the inverse relationship between red wine consumption and mortality from ischemic heart disease in 18 different European and American countries. This report followed the observations of previous investigators of the association between alcohol consumption and the low incidence of coronary artery disease (CAD). 2 Klatsby A.L. Friedman G.D. Siegalub A.B. Alcohol consumption before myocardial infarction. Ann Intern Med. 1974; 81 : 294-301 Crossref PubMed Scopus (229) Google Scholar ,  3 Hennekens C.H. Robner B. Cole D. Daily alcohol consumption and fatal coronary heart disease. Am J Epidemiol. 1978; 107 : 196-200 PubMed Google Scholar ,  4 Yano K. Rhoads G.G. Kagan A. Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. N Engl J Med. 1977; 297 : 405-409 Crossref PubMed Scopus (406) Google Scholar In 1992, Renaud and associates 5 Renaud S. de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992; 339 : 1523-1526 Abstract PubMed Scopus (2935) Google Scholar introduced the term French Paradox to underscore the low mortality rate from ischemic heart disease among people in France despite the high amount of saturated fats in their diet, 5 Renaud S. de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992; 339 : 1523-1526 Abstract PubMed Scopus (2935) Google Scholar ,  6 Teissedre P.L. Waterhouse A.L. Inhibition of oxidation of human low density lipoproteins by phenolic substances in different essential oils varieties. J Agric Food Chem. 2000; 48 : 3801-3805 Crossref PubMed Scopus (180) Google Scholar ,  7 Howard A. Chopra M. Thurnham D. et al. Red wine consumption and inhibition of LDL oxidation what are the important components?. Med Hypotheses. 2002; 59 : 101-104 Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar ,  8 Saucier C.T. Waterhouse A.L. Synergetic activity of catechin and other antioxidants. J Agric Food Chem. 1999; 47 : 4491-4494 Crossref PubMed Scopus (81) Google Scholar ,  9 Araim O. Ballantyne J. Waterhouse A. Sumpio B.E. Inhibition of vascular smooth muscle cell proliferation with red wine and red wine polyphenols. J Vasc Surg. 2002; 35 : 1226-1232 Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar which is usually associated with increased mortality from CAD. They attributed this unusual occurrence to red wine consumption based on the findings of the MONICA (MONItoring system for CArdiovascular disease) project, a worldwide program organized by the World Health Organization. Collaborating researchers from 21 countries studied more than 7 million men and women (35 to 64 years of age) from 37 mostly European populations over a period of 10 years, from the mid-1980s to the mid-1990s. The investigators observed a lower mortality rate from CAD in France compared with that in the United Kingdom and the United States, despite the high consumption of saturated fats and similar serum cholesterol concentrations. In addition, other risk factors such as blood pressure, body mass index, and cigarette smoking were equivalent in France to what they were in other industrialized countries ( Table 1) . 10 Tunstall-Pedoe H. Kuulasmaa K. Mahonen M. et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality 10-year results from 37 WHO MONICA Project populations. Lancet. 1999; 353 : 1547-1557 Abstract Full Text Full Text PDF PubMed Scopus (1211) Google Scholar ,  11 Kuulasmaa K. Tunstall-Pedoe H. Dobson A. et al. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the MONICA Project populations. Lancet. 2000; 355 : 675-687 Abstract Full Text Full Text PDF PubMed Scopus (757) Google Scholar Although France and Italy have halved their wine consumption from what it was in the 1960s, and now average 67 and 57 L/capita/year, respectively, these countries still have a much higher intake than the United Kingdom or the United States, where consumption is about 12 and 5 L/capita/year, respectively. 12 Yarnell J.W. The Mediterranean diet revisited-toward resolving the (French) paradox. Q J Med. 2000; 93 : 783-785 Crossref Scopus (25) Google Scholar Table 1 Mortality from Coronary Artery Disease and Relative Risk Factors (MONICA Populations; 35–64 Years) MONICA center Annual CAD mortality/100,000 population Mean serum cholesterol (mmol/L) Mean systolic blood pressure (mmHg) Proportion of regular cigarette smokers (%) Body mass index (kg/m 2) Men Women Men Women Men Women Men Women Men Women Japan * * Population not part of MONICA project. CAD, coronary artery disease; MONICA, monitoring system for cardiovascular disease. 33 9 — — — — — — — — Beijing, China 46 26 4.5 4.5 131 130 64 9 24.1 24.5 Toulouse, France 53 9 5.8 5.6 125 117 24 22 26.1 24.5 Strasbourg, France 80 17 6.0 5.9 135 127 23 15 27.3 26.2 Lille, France 89 16 5.8 5.8 135 129 33 17 26.4 26.4 Friuli, Italy 99 18 5.9 5.7 140 134 29 22 26.9 25.8 A. Brianza, Italy 103 21 5.9 5.9 131 127 34 23 26.4 25.5 Halifax, Canada 176 38 5.6 5.8 130 126 32 25 27.5 27.6 Stanford, CA, USA 163 51 5.4 5.3 129 119 23 19 26.9 26.6 Belfast, UK 280 79 5.9 5.9 135 129 29 25 26.3 25.6 Glasgow, UK 332 114 6.1 6.1 133 126 41 41 26.8 26.9 Data from Tunstall-Pedoe et al 10 Tunstall-Pedoe H. Kuulasmaa K. Mahonen M. et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality 10-year results from 37 WHO MONICA Project populations. Lancet. 1999; 353 : 1547-1557 Abstract Full Text Full Text PDF PubMed Scopus (1211) Google Scholar and Kuulasmaa et al. 11 Kuulasmaa K. Tunstall-Pedoe H. Dobson A. et al. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the MONICA Project populations. Lancet. 2000; 355 : 675-687 Abstract Full Text Full Text PDF PubMed Scopus (757) Google Scholar * Population not part of MONICA project. CAD, coronary artery disease; MONICA, monitoring system for cardiovascular disease. Open table in a new tab