Elsevier

Cardiology Clinics

Volume 21, Issue 3, August 2003, Pages 449-457
Cardiology Clinics

Review article
Beyond the French paradox: the impact of moderate beverage alcohol and wine consumption in the prevention of cardiovascular disease

https://doi.org/10.1016/S0733-8651(03)00081-XGet rights and content

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

First page preview

First page preview
Click to open first page preview

References (50)

  • Lancet editorial. The hidden epidemic of cardiovascular disease

    Lancet

    (1998)
  • A.L. Klatsky et al.

    Alcohol and mortality

    Ann Intern Med

    (1992)
  • C.A. Carmargo et al.

    Moderate alcohol consumption and risk for angina pectoris in myocardial infarction in US male physicians

    Ann Intern Med

    (1997)
  • S.C. Renaud et al.

    Wine, beer, and mortality in middle aged men from eastern France

    Arch Intern Med

    (1999)
  • I.J. Goldberg et al.

    AHA science advisory: wine and your heart: a science advisory for healthcare professionals from the nutrition committee, council on epidemiology and prevention, and council on cardiovascular nursing of the American Heart Association

    Circulation

    (2001)
  • R.C. Ellison

    AHA science advisory on wine and health: a confusing message about alcohol consumption

    Circulation

    (2001)
  • Encarta World English Dictionary,...
  • E.M. Tuzcu et al.

    High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound

    Circulation

    (2001)
  • Ellison RC. Linking wine to cardiovascular health. In: Program and abstracts of the Second International Wine and Heart...
  • G.J. Soleas et al.

    Wine as a biological fluid: history, production, and role in disease prevention

    J Clin Lab Anal

    (1997)
  • Wemyss N. Wine and civilization: bulletin of the Society of Medical Friends of Wine...
  • A.L. Klatsky

    Commentary: could abstinence from alcohol be hazardous to your health?

    Int J Epidemiol

    (2001)
  • F. Stare

    Myocardial infarction in patients with portal cirrhosis

    Nutr Rev

    (1961)
  • A.S. St Leger et al.

    Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine

    Lancet

    (1979)
  • M. Gronbaek et al.

    Type of alcohol consumed and mortality from all causes, coronary heart disease, and cancer

    Ann Intern Med

    (2000)
  • Cited by (0)

    View full text