High-altitude pulmonary edema (HAPE) is the predominant cause of death due to high-altitude illness. At first sight, the observation that mountaineers regularly consume red wine in order to "feel better" seems to be paradoxical because, especially at higher altitudes, alcohol consumption could be detrimental. In this article, we review the potential mechanisms by which the components of red wine may beneficially affect the development of HAPE.
Data synthesis: The underlying cause of HAPE is the altitude-related reduction in barometric pressure, which leads to a decrease in partial pressure of oxygen in the alveolae and subsequently in the pulmonary capillaries and arterial system. Two cellular mechanisms have been described, both of which increase pulmonary vascular tone: enhanced endothelin 1 production and the increased generation of reactive oxygen species. Recent evidence has indicated that some of the compounds of red wine suppress endothelin 1 gene expression, and the anti-oxidative properties of red wine have been previously reported.
Conclusion: This article briefly summarises the pathophysiological cellular events leading to HAPE and describes the potential mechanisms by which the ingredients of red wine may have a beneficial effect.