Drinking a moderate amount of wine may lower the risk of serious cardiovascular disease in people at high risk

Drinking a small or moderate amount of wine may lower the risk of serious cardiovascular disease in higher-risk people who follow a Mediterranean diet, according to research published in the European Heart Journal.

Previous studies on the effects of wine on cardiovascular health have produced inconsistent results. This may be partly because research often relies on people reporting how much wine they drink. Instead, in the new study, researchers measured the amount of a chemical called tartaric acid in the participants’ urine. Researchers say this is an ‘objective and reliable measure’ of wine consumption.

The research was led by Professor Ramon Estruch from the University of Barcelona and the Hospital Clinic Barcelona, ​​Spain.

The new research is part of a larger Spanish study on the effect of a Mediterranean diet (rich in olive oil, vegetables, fruit, nuts and fish, and low in sweet or processed foods and drinks) on people at higher risk of developing cardiovascular disease. disease.

All participants did not have cardiovascular disease at the start of the study, but did have type 2 diabetes, or a combination of risk factors for cardiovascular disease, such as smoking, high blood pressure, high cholesterol, being overweight and/or a family history of cardiovascular disease. vascular diseases.

In addition to filling out questionnaires about what they ate and drank, participants provided urine samples at the start of the study and after following a Mediterranean diet for a year. Tartaric acid is a chemical that occurs naturally in grapes and grape-derived products such as wine. Tartaric acid is excreted through the urine, allowing it to be measured whether someone has drunk wine and/or grapes in the past five to six days.

To investigate the effect of drinking wine, the researchers enrolled a total of 1,232 participants. The participants were followed for four to five years, during which time there were 685 cases of cardiovascular disease (heart attack, coronary revascularization, stroke, or death from cardiovascular disease) during the study.

In this group of people at high risk for cardiovascular disease who followed a Mediterranean diet, researchers found that the risk of developing cardiovascular disease was reduced by 50% in light to moderate wine drinkers, defined as consuming a half to one glass of wine. wine per day, compared to those who drink very little or no wine.

Light drinking (between one glass per week and less than half a glass per day) reduced cardiovascular risk by 38%. However, this protective effect disappears in people who drink more than one drink per day.

The researchers took into account other factors known to influence the risk of cardiovascular disease, but they acknowledge that the design of the study means it can only show a link between drinking wine and cardiovascular disease, and that other factors cannot be excluded.

Professor Estruch said: ‘By measuring tartaric acid in urine, in addition to food and drink questionnaires, we have been able to measure wine consumption more accurately. We found a much greater protective effect of wine than has been observed in other studies. A risk reduction of 50% is much higher than can be achieved with some medications, such as statins.

“This study examines the importance of moderate wine consumption within a healthy diet, such as the Mediterranean diet. Until now, we believed that 20% of the effects of the Mediterranean diet could be attributed to moderate wine consumption; in light of these results, the effect may be even greater.

“The participants in our study were elderly people at high risk of cardiovascular disease living in a Mediterranean country, so the results may not apply to other populations. Another important question is at what age moderate wine consumption is considered ‘acceptable’ ‘ can be considered.

“Recent studies indicate that the protective effects of wine consumption are observed from the age of 35 to 40 years. It is also important to note that moderate consumption for women should always be half that of men, and that at the meal must be consumed.”

In an accompanying editorial, Professor Giovanni de Gaetano from IRCCS NEUROMED, ​​Pozzilli, Italy and colleagues said: “The relationship between alcohol consumption, particularly wine, and the risk of cardiovascular disease (CVD) remains a subject of ongoing debate, despite decades of related research.

“Numerous studies have suggested that moderate wine consumption, often defined as one glass per day, preferably with meals, is associated with a reduced risk of all-cause mortality and cardiovascular disease. However, this apparent protective effect is clouded by persistent uncertainties.

“The article by Inés Domínguez-López et al, published in this issue of the European Heart Journalsheds new light on this complex relationship by introducing an objective biomarker – urinary tartaric acid – as a measure of wine consumption and provides compelling evidence for its association with a lower risk of cardiovascular disease.

“However, Domínguez-López et al. also emphasize the complexity of studying the effects of alcohol on health. Although biomarkers such as urine tartaric acid provide a more objective measure of wine exposure, they do not reflect the broader context of alcohol consumption, such as drinking patterns, lifestyle factors and potential interactions with other dietary components.

“This limitation underlines the need for more sophisticated research that captures the complexity of dietary patterns and their impact on health.

“The study by Domínguez-López et al. represents an important step forward in our understanding of the complex relationship between wine consumption and cardiovascular health. Using urinary tartaric acid as an objective biomarker, the authors provide robust evidence that moderate wine consumption is associated with lower CVD risk in a Mediterranean population at high cardiovascular risk.

“This work not only highlights the value of objective biomarkers in nutritional epidemiology, but also supports the idea that light to moderate wine consumption can be part of a heart-healthy diet. However, the findings also remind us of the risks associated with higher levels of consumption, underscoring the importance of moderation.

“Future research should continue to explore the potential of biomarkers in unraveling the complicated links between diet, lifestyle and health outcomes.”