Red wine and atherosclerosis: Implications for the Mediterranean diet

Abstract Cardiovascular disease (CVD) is the leading cause of death globally. Atherosclerosis, the disease that underlines ischemic CVD, is a nonresolving inflammatory condition mainly characterized by the buildup of cholesterol in the arteries. However, atherosclerosis involves not only dyslipidemia and inflammation but also oxidative stress. Unraveling the mechanisms that tie these conditions is the key to cardioprotection. Moderate consumption of red wine has been widely associated with reduced cardiovascular risk, mainly due to its composition in phenolic compounds with antioxidant activity, such as resveratrol. This review focuses on biological activity of red wine and its phenolic compounds against cardiovascular disease. Special attention is drawn to dyslipidemia, inflammation, and oxidative stress. The strongest pieces of evidence for red wine cardioprotection lie on animal studies that show decreased platelet aggregation, antioxidant effects, and reduced inflammation associated to red wine intake. Larger long-term clinical trials and epidemiological studies are needed, before this cardiovascular protection can be truly evidenced and physiological mechanisms elucidated.