Cardiology Patient Page
Red Wine and Your Heart
Paul E. Szmitko, BSc; Subodh Verma, MD, PhD
Drinking red wine has been portrayed by the media as a means of combating heart disease. Do these claims have any real medical basis? The main health benefit of moderate alcohol use appears to be related to its effect on the development of
atherosclerosis or the accumulation of fatty plaques in the blood vessels, particularly the coronary arteries that supply the heart. These deposits decrease blood flow to the heart and may promote the formation of vessel-blocking clots, which can result in anginal chest pain or even a life-threatening heart attack. In this article, we examine the scientific literature behind these claims, both epidemiological (studies focused on disease within whole populations) and biological (studies focused on how the molecular components of red wine affect atherosclerosis).
The moderate consumption of alcoholic beverages, defined as 1 to 2 drinks per day, has been suggested to increase overall survival rates in a number of different population groups. One standard drink is generally considered to be 1.5 oz of liquor, 5 oz of wine, or 12 oz of beer. The patient groups that appear to benefit most from light to moderate drinking, middle-aged men and women, are also those who are at increased risk for developing cardiovascular disease. Thus, the reduction in total mortality that is associated with moderate alcohol consumption, generally a 30% reduction in risk, is believed to be the result of a reduction in the risk of developing atherosclerotic disease.
When the data from 51 epidemiological studies were combined, they showed that the risk of coronary heart disease decreased by approximately 20% when 0 to 2 alcoholic drinks were consumed per day. Apparently healthy adults, patients with a history of heart attack, and patients with diabetes all appeared to benefit. Results from the large Health Professionals Follow-Up Study,
a study in which 38,077 male health professionals who were free of cardiovascular disease were observed for 12 years, suggested that drinking 1 to 2 drinks per day, 3 to 4 days per week decreased the risk of having a heart attack by as much as 32%. The formation of an occluding blood clot in an artery that supplies part of the brain can lead to stroke. Light to moderate alcohol consumption was found to be associated with an approximately 20% reduction in the risk for ischemic stroke and may even be beneficial in preventing subsequent strokes.
Alcohol intake from any type of alcoholic beverage appears to be beneficial, but some studies suggest that red wine confers additional health benefits.
The regular drinking of red wine has been suggested as the explanation for the “French paradox,” the relatively low incidence of coronary atherosclerosis in France as compared with other Western countries, despite the generally high intake of saturated fat in the French diet. Support for a more pronounced cardioprotective effect for red wine as compared with other alcoholic beverages first emerged from the Copenhagen City Heart Study, in which
13,285 men and women were observed for 12 years. The results from this study suggested that patients who drank wine had half the risk of dying from coronary heart disease or stroke as those who never drank wine. Those who drank beer and spirits did not experience this advantage. The additional benefit of red wine is supported further by an analysis of 13 studies involving 209,418 participants. This analysis showed a 32% risk reduction of atherosclerotic disease with red wine intake, which was greater than the 22% risk reduction for beer consumption. Other studies and reviews have failed to show a beneficial effect for red wine, however, and hence it could be concluded that other lifestyle factors such as diet, exercise, socioeconomic status, or pattern of alcohol consumption may have played a role in giving wine drinkers an advantage in lowered rates of atherosclerosis.
The chemical composition of red wine may contribute to its apparent benefit. A series of scientific studies suggests that the polyphenolic compounds in red wine, such as flavonoids and resveratrol, may play an active role in limiting the start and progression of atherosclerosis.