Review articleBeyond the French paradox: the impact of moderate beverage alcohol and wine consumption in the prevention of cardiovascular disease
Section snippets
Prevention
In our society, CVD is the leading cause of death and prevention is vital to longer life and better health. Encarta World English Dictionary defines prevention as, “an action that stops something from happening” [8]. Although patients with CHD typically become symptomatic after age 40 years, studies indicate that CHD begins very early in life, such that by the age risk management and prevention is emphasized, many patients already have established vascular disease. In a study of cardiac
History of alcohol and health
Through the ages, beverage alcohol, particularly wine, has been touted as an elixir for better health. Records of civilization spanning over thousands of years show evidence of fermentation and winemaking [11]. Fermentation was exploited for preserving foods and making food more nutritious. Accounts of ancient societies show evidence of wine consumption in moderation, and noted these earliest wine consumers to be better nourished and less prone to sickness [12]. Judaic records described “wine
Epidemiology
St. Leger and colleagues [15], studied variables associated with cardiovascular death in 18 developed countries. There was a strong and specific negative association between cardiac deaths and alcohol consumption, and the association seemed to be entirely because of wine consumption. Cigarette consumption, a strong cardiac risk factor, and total fat and caloric food intake, were positively associated with cardiac death. Gross national product per capita, an indicator of affluence and social
Biology of alcohol and wine
Classically, the mechanism of CVD risk reduction for alcohol drinkers has been believed to be caused by the significant rise in HDL-C associated with alcohol consumption; At least 50% of the benefit has been attributed to HDL-C rise, an effect not unique to wine [21]. With the increasing interest in the protective role that HDL-C plays in the prevention of CVD, there is good reason to consider the effects that moderate alcohol consumption can add to current preventative and therapeutic
Alcohol and wine in vascular biology
Possibly, the most interesting effect of alcohol consumption, and wine, is its effects on vascular biology and atherogenic mechanisms. As we have seen, alcohol has fundamental benefits on HDL-C, and platelets and hemostasis, and these effects are significant. For this reason, differentiating benefits unique to wine, compared with other alcohol beverages has been difficult and inconsistent. Furthermore, wine drinkers tend to be higher educated, belong to a higher socioeconomic class, are leaner
Inflammation and vascular remodeling
C-Reactive protein is an emerging marker for acute CHD and has been associated with a significantly higher mortality in patients presenting with acute ischemic coronary syndromes [42]. Moderate red wine consumption has anti-inflammatory properties, and is associated with a lowered level of CRP. In a study of 2008 men and women, ages 18 to 88 years, alcohol consumption showed a U-shaped association with mean values of CRP [43]. Paralleling the J or U-shaped curves for total and coronary
Summary
Alcohol beverages, particularly red wine, when consumed in moderation reduce the risk of acute CVD and death. Important questions and issues, however, still remain, including the role of beverage type, pattern of drinking, and the risk that moderate drinking can lead to problem drinking.
The mechanism for alcohol beverage benefit is complex, and includes an independent benefit of ethyl alcohol. The multiplicity of effects identified for the non-alcohol components of red wine, play a role in
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