The relationship between wine consumption and cardiovascular risk: from epidemiological evidence to biological plausibility.

Epidemiological studies have suggested that cardiovascular disease morbidity and mortality can be decreased by moderate alcohol consumption. Several recent studies have also separately assessed the relative risk associated with different types of alcoholic beverages. The evidence obtained strongly suggests, although does not prove, that there is a major beneficial effect from drinking a low-moderate amount of wine. A meta-analysis has recently been performed on 19 of these studies, selected on the basis of the availability of specific information on the relative risk associated with wine consumption. The results indicate a negative association of moderate (up to 300 ml per day) wine consumption with the risk of cardiovascular events. Although some cardioprotective effects of alcoholic beverages are probably due to ethanol-induced elevation of HDL cholesterol, lowering of fibrinogen plasma levels and, perhaps, of platelet aggregation, it is reasonable to speculate that the cardiovascular protective effects of wine, observed in French and in other populations, may be attributed in part to the antioxidant, vasorelaxant, and antithrombotic properties of its polyphenolic components.