Cardiovascular System

Throughout the developed world, cardiovascular disease is the leading cause of death and accounts for up to 50% of all deaths. Considering this, it is of outmost relevance that epidemiological studies are showing consistently a reduced mortality from coronary heart disease (CHD) and other forms of cardiovascular diseases (CVD) by 25-30% in middle-aged and elderly individuals.

Moderate wine drinkers seem to live longer than those who abstain or drink heavily. This widely accepted association is known as the J-curve. The relative risk of dying from CVD is lowest among light to moderate drinkers and greater among abstainers. However, the risk increases steadily with each drink above moderation. Thus, while one or two glasses can be considered “good for your health”, drinking more than the guidelines will not provide more benefits, only more harm!

In a recent most comprehensive meta-analysis, an international research team examined results from 84 longitudinal cohort studies from all over the world comparing drinkers of alcoholic beverages with non-drinkers for the outcomes of overall mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD) and stroke as well as incident coronary heart disease and incident stroke.
Meta-analyses for each of these outcomes were performed. The researchers carefully accounted for possible confounding factors.

As result, the cardiovascular mortality risk for drinkers of alcoholic beverages compared to non-drinkers was significantly reduced by 25%. Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 15-30 g of alcohol a day but for stroke mortality ≤ 15 g of alcohol a day. Very importantly, also with regards to all cause mortality, moderate drinkers had an advantage compared to abstinent individuals: up to 15 g/day, their total mortality risk was 13% lower.
The scientists concluded that light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes and total mortality and further, they suggested that current scientific data indicate causality.

The results of another meta-analysis concerning the biochemical and physiological mechanisms showed that moderate consumption of alcoholic beverages (up to 15 g alcohol a day for women and up to 30 g alcohol a day for men) has beneficial effects on a variety of biomarkers linked to the risk of coronary heart disease.

 

Mechanisms

Approximately half of the cardio-protective effects of wine are believed to be due to alcohol itself since it has a beneficial effect on blood lipids.

Vascular disease occurs when bad cholesterol (LDL) is deposited in artery walls and builds up atherosclerotic deposits, eventually rupturing, causing a clot to form which can instantaneously block mostly or completely the flow through the coronary artery. Alcohol stimulates the production of the “good” high density lipoprotein cholesterol (HDL) which is believed to remove cholesterol deposits from arteries and veins where it can form plaques.

It also reduces the “stickiness” or the clotting together of red blood cells which could form a clot and block the blood flow in an artery (thrombosis) resulting in a heart attack or stroke. In addition, it lowers the fibrinogen level which is a pro-inflammatory, thus alcohol works as an anti-inflammatory agent that affects the blood vessels positively and is involved in delaying the development of atherosclerosis.

Wine, in addition, contains phenolic substances
such as resveratrol, anthocyanins, flavonols and catechins which act as antioxidants and inhibit “bad” LDL cholesterol from being incorporated in the artery wall. These antioxidants also reduce the damage caused by the body's free radicals (toxic waste products) which contribute to causing degenerative diseases in the body such as cancer, Alzheimer's disease, Parkinson's disease and ageing. Furthermore, rather than the phenolic compounds themselves, their metabolites might be the real key players in cardiovascular and cancer protection. It should be noted that the antioxidant activity in unfermented grape juice is lower than in the finished wine - antioxidant activity increases during fermentation and maturation. Antioxidant levels will depend on the processing, filtering as well as on the variety, vintage, altitude and soil.

The phenolic compounds are also associated with reducing blood clotting and also maintaining the ability of the blood vessel wall to expand and contract.

The findings described in
the above quoted meta-analyses provide the most thorough examination of the literature and strengthen the case for a causal link between alcohol intake and a reduced risk of coronary heart disease, suggesting that the lower risk of heart disease observed among moderate drinkers is caused by the alcoholic beverage itself, and not by other associated lifestyle factors. The scientific evidence is very convincing that regular moderate consumption of alcoholic beverages, in particular wine,  can provide cardiovascular benefits in older adults.

 

Blood Pressure

High blood pressure (hypertension) occurs when vessel walls lose their flexibility causing excess pressure on arterial walls. If the elevated blood pressure is not reduced, the risk of heart disease, stroke, visual loss, and kidney failure increases. Early detection and treatment is lifesaving. The treatment often involves a modification of lifestyle. It has been a general, long-held belief that consumption of alcoholic beverages, in any form, in any quantity, raises blood pressure, and, therefore, many of those at risk have been advised not to drink at all.

Epidemiological studies suggest a lower risk of morbidity and mortality among lighter drinkers. The investigators found that the association between intake of alcoholic beverages and risk of cardiovascular disease (CVD) followed a J-shaped curve, whereas  alcohol drinking is linearly associated with blood pressure, and the CVD risk also increases  linearly according to blood pressure level.  However, several studies indicate that moderate wine consumption does not increase or can even decrease blood pressure. This effect seems mostly due to relaxed blood vessels immediately after consuming alcoholic beverages.
The non-alcoholic elements of wine, such as polyphenols may have additional antioxidant, anti-inflammatory and blood vessel relaxant properties.

International comparisons and some prospective research data suggest that wine is more protective against coronary heart disease (CHD) than liquor or beer. Possibly beneficial non-alcohol compo­nents in wine may exert the extra protection by wine, but a healthier drinking pattern or more favorable risk traits in wine drinkers (such as a healthier lifestyle) may be involved. Heavy drinking or a binge drinking pattern definitely associated with an increased risk of hypertension. Reducing the intake of alcoholic beverages to moderate levels often leads to substantial reduction of elevated blood pressure.

The above summary provides an overview of the topic, for more details and specific questions, please refer to the articles in the database.

BACKGROUND: Both blood pressure and HDL cholesterol are affected by alcohol drinking. However, it has not been determined whether association of alcohol drinking with blood pressure varies depending on blood HDL level. METHODS: The subjects were male workers aged 20 to 29 year and 50 to 59 year (n = 21,301), representing young and middle ages, respectively, who had received periodic health checkup examinations. The subjects were divided into tertile groups by serum HDL level, and they were further divided into 3 subgroups based on the average daily alcohol intake [nondrinkers, light drinkers (
OBJECTIVE: To determine whether body weight influences the associations of habitual alcohol drinking with blood pressure and serum lipids in women. METHODS: The subjects were 16,805 healthy women at ages of 35-54 years, and data were collected at work places of the subjects in Yamagata Prefecture in Japan from April 1999 to March 2000. The subjects were divided into three tertile groups of body weight and were further divided into three subgroups by average ethanol intake [non-, light ( or =15 g per day) drinkers]. RESULTS: In the first and second tertile groups of body weight, mean systolic and diastolic blood pressure and prevalence of high systolic or diastolic blood pressure were significantly higher in heavy drinkers than in non-drinkers,…
OBJECTIVE: Triglycerides-to-high-density-lipoprotein (HDL)-cholesterol ratio (TG/HDL-C ratio) has been proposed to be a useful predictor of cardiovascular disease. Habitual alcohol drinking causes elevation of triglycerides and HDL cholesterol levels. The purpose of this study was to determine how the TG/HDL-C ratio is influenced by alcohol intake. METHOD: Subjects were 21,572 Japanese men (age range: 35-60 years) who were divided into non-, light (/=22 but /=44 g ethanol/day) drinkers. The relationship between alcohol intake and TG/HDL-C ratio was investigated by using analysis of covariance and logistic regression analysis. RESULTS: Log-transformed TG/HDL-C ratio was significantly lower in light, heavy, and very heavy drinkers than in nondrinkers and was lowest in light drinkers. Odds ratios for high TG/HDL-C ratios in light and heavy drinkers…
BACKGROUND: Serum non-HDL cholesterol is a strong predictor of cardiovascular diseases. We studied the relationship between habitual alcohol drinking and non-HDL cholesterol. METHODS: Healthy male subjects (n = 27,005) and female subjects (n = 16,805) were divided into 5 groups by average daily ethanol intake. Serum non-HDL cholesterol level and prevalence of serum high non-HDL cholesterol (> or = 170 mg/dl) were compared among the groups. RESULTS: Non-HDL cholesterol level and prevalence of high non-HDL cholesterol became lower as alcohol intake increased. The threshold alcohol intake in the drinker groups showing significantly lower non-HDL cholesterol level and significantly lower prevalence of high non-HDL cholesterol, compared with those in non-drinkers, was lower in women ( or = 10 and

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