Wine intake inversely tied to CV outcomes

A systematic review and meta-analysis showed an inverse relationship between wine consumption and the risks of cardiovascular (CV) mortality, CV disease (CVD), and coronary heart disease (CHD).

Evidence has shown a J-shaped relationship between wine consumption and CV events, suggesting that low-to-moderate wine intake may help promote better health. [Eur J Epidemiol 2011;26:833-850; Circulation 2002;105:2836-2844] “Our results confirm existing data that moderate wine consumption can be inversely associated with CV outcomes such CV mortality, CVD, and CHD,” said the researchers.

This systematic review included 25 trials, 22 of which were included in the meta-analysis. Using the DerSimonian and Laird approach, the pooled relative risk (RR) for the association between wine consumption and CHD risk was 0.76. For the risks of CVD and CV mortality, the corresponding pooled RRs were 0.83 and 0.73. [Nutrients 2023;15:2785]

“Mean age, percentage of women, follow-up duration, or percentage of current smokers did not appear to influence this association,” they said.

Stronger effect than other alcohols

Some dietary patterns (eg, Mediterranean diet) recommend wine consumption. “Wine seems to have a stronger beneficial effect on CVD than other alcoholic beverages,” the researchers noted.

The phenolic compounds present in wine reduce low-density lipoprotein (LDL) oxidation, thrombosis risk, plasma, and lipid peroxide, while its alcohol components reduce the risk of thrombosis and fibrinogen levels and induce collagen and platelet aggregation. [J Nutr 2001;131:1401-1404]

De-alcoholized wines could also produce a protective effect against thrombosis and deliver antioxidant effects. [J Am Coll Cardiol 1994;655:A66; Lancet 1993;341:454-457]

With red wine, the beneficial effect could be attributed to the composition of grape skins, which are made up of polyphenols that have antioxidant properties. Depending on the grape variety, these polyphenols may include gallic acid and polymeric anthocyanins, quercetin, myricetin, catechin, and epicatechin. [Heart 1999;81:459-460]

Furthermore, the resveratrol in red wine provides a host of CV benefits, the researchers noted. “[It] inhibits LDL oxidation, promotes endothelial relaxation, suppresses platelet aggregation, and has anti-atherosclerotic functions.”

However, these pros should be weighed against the cons. “Caution must be taken regarding the interaction of resveratrol with certain drugs, as evidence has shown that alcohol can modify their metabolism. These alterations cause drugs to reach the blood in smaller quantities … [H]igh doses of resveratrol in anticoagulated patients may increase the risk of haematomas and haemorrhages,” they pointed out.

Individuals vulnerable to alcohol due to age, medication, or pathology should also be taken into consideration. “Increasing wine consumption could be detrimental to these patients … Our findings should thus be interpreted with caution,” they said.

Limitations

The researchers did not look into the correlation between wine consumption and CV mortality, CVD, and CHD by wine type or sex. “Although the analysis of the effect of wine consumption on total mortality could be of interest to our purpose, a lack of data prevented us from carrying out this analysis,” they said.

The exclusion of grey literature and restriction to English- and Spanish-language trials may have also limited the findings. Not all included studies had the same confounders, and most studies did not reflect the amount of wine consumed.

Furthermore, wine could have been consumed with other types of alcohol in some studies. “This could have interfered with the results,” said the researchers.