Elsevier

Atherosclerosis

Volume 195, Issue 2, December 2007, Pages e176-e181
Atherosclerosis

A moderate dose of red wine, but not de-alcoholized red wine increases coronary flow reserve

https://doi.org/10.1016/j.atherosclerosis.2007.06.004Get rights and content

Abstract

Background

Red wine consumption is associated with reduced cardiovascular disease mortality. Its cardioprotective properties may be partly related to its ability to improve endothelial function. The purpose of this randomized controlled cross-over study was to determine whether moderate doses of red wine and de-alcoholized red wine improve coronary flow velocity reserve (CFR).

Methods

Using transthoracic Doppler echocardiography, 176 CFR measurements were made in 22 healthy men before and after ingestion of a moderate (4.0 ± 0.4 dl) and an escalating high dose (total amount 8.1 ± 0.9 dl) of alcohol-containing red wine and de-alcoholized red wine, which contained similar amounts of phenolic substances. The difference in plasma antioxidant capacity was determined by colorimetric assay kit.

Results

Red wine increased CFR from 3.8 ± 1.4 to 4.5 ± 1.4 (p < 0.01) and 4.0 ± 1.2 (p = NS) after moderate and high doses, respectively; whereas de-alcoholized red wine had no significant effects on CFR (4.0 ± 0.7, 4.3 ± 1.3 and 4.5 ± 1.4, respectively). Plasma antioxidant capacity increased significantly after high dose of red wine (27.5 ± 14.7%, p < 0.001), but not after de-alcoholized red wine (0.5 ± 10.5%, p = NS) despite similar amounts of phenolic substances. Differences between CFR and plasma antioxidant capacities before and after drinking had no significant association.

Conclusions

A moderate dose of red wine, but not de-alcoholized red wine increases CFR. The increase of CFR is probably mediated by other than direct antioxidant properties of polyphenols, because the simultaneous increase of CFR and plasma antioxidant capacity were not associated.

Introduction

Moderate consumption of red wine is associated with reduced coronary artery disease mortality [1], [2]. The cardioprotective effects of red wine may be partly related to its ability to improve endothelial function [3]. Red wine increases the endothelium-dependent flow-mediated dilatation of the brachial artery acutely after ingestion [4], [5], [6]. Moreover, a high dose of red wine (ethanol 1.0 g/kg) has been shown to increase coronary flow velocity reserve (CFR) as measured with transthoracic Doppler echocardiography, whereas pure alcohol and white wine had no such effect [7]. CFR depicts the relative increase of coronary blood flow in response to maximal myocardial hyperemia induced by adenosine. It is reduced in early stages of coronary atherosclerosis [8] and various conditions associated with the dysfunction of coronary microcirculation, such as diabetes [9] and hypercholesterolemia [10].

The beneficial vasodilatory effects of red wine have been attributed to both ethanol and antioxidative polyphenols [11], [12]. However, their relative contributions in vivo remain to be established. Moreover, the bioavailability of the antioxidant content of red wine has not been addressed simultaneously with CFR measurements. It has been suggested that red wine has better vasoactive properties than other alcohol beverages, and even de-alcoholized red wine may be sufficient to improve the flow-mediated dilatation of the brachial artery [4].

The purpose of this randomized controlled cross-over study was to determine with transthoracic echocardiography whether moderate doses of red wine improve CFR in response to adenosine in healthy humans. We also studied the contributions of ethanol and antioxidants by comparing the effects of equal doses of alcoholic and de-alcoholized red wine on plasma antioxidant capacity and CFR.

Section snippets

Subjects and study protocol

The study included 22 healthy, non-smoking Finnish men (mean age 23 ± 1.8 years, body mass index 24 ± 2.3 kg/m2, total cholesterol 4.2 ± 0.8 mmol/l, HDL cholesterol 1.6 ± 0.41 mmol/l, LDL cholesterol 2.3 ± 0.65 mmol/l, triglycerides 0.77 ± 0.21 mmol/l and plasma glucose 5.0 ± 0.46 mmol/l). None of the subjects were taking any medication. One subject dropped out of the study because of red wine-related headache. The study was carried out in accordance with the Declaration of Helsinki (2000) of the World Medical

CFR

Table 1 shows the effects of the study beverages on coronary mean diastolic velocities. Red wine increased CFR from 3.8 ± 1.4 to 4.5 ± 1.4 (p < 0.01) and 4.0 ± 1.2 (p = NS) after moderate and high doses, respectively (see Fig. 2 and Table 2). De-alcoholized red wine had no significant effects on CFR (4.0 ± 0.7, 4.3 ± 1.3 and 4.5 ± 1.4, respectively).

Antioxidant capacity

Plasma antioxidant capacity increased from 265 ± 35.0 to 333 ± 29.3 μmol/l by 27.5 ± 14.7% (p < 0.001) after red wine. De-alcoholized red wine had no effect on plasma

Discussion

This randomized controlled cross-over study demonstrates that a moderate dose of red wine increases CFR as measured with transthoracic echocardiography. Red wine also increases plasma antioxidant capacity. Despite similar amount of antioxidant polyphenols, de-alcoholized red wine has no effect on either CFR or plasma antioxidant capacity.

A previous study suggested that a high dose of red wine (ethanol 1.0 g/kg) improves CFR [7]. Importantly, improving CFR appeared to be a unique feature of red

Conflict of interest

None.

Acknowledgements

Funding: This study was supported by The Turku University Hospital Research Foundation, the Tampere University Hospital Medical Fund, the Turku University Foundation, the Emil Aaltonen Foundation, the Orionpharma Research Foundation, the Instrumentarium Research Foundation and the Paulo Foundation.

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