Red Wine and Cardiovascular Disease 1 Lindsay Wexler 5/2/09 NFSC 345 Red Wine and Cardiovascular Disease Does consuming red wine prevent cardiovascular disease? Side 1: Red wine consumption prevents cardiovascular disease Side 2: Red wine consumption promotes cardiovascular disease. Introduction Red wine s relationship with cardiovascular disease is a very popular topic because cardiovascular disease is so prevalent in the world, and especially in the United States. Also, red wine is widely consumed and has been suggested to lower the risk of cardiovascular disease. Based on the conflicting evidence from investigating research articles, the link between red wine consumption and cardiovascular disease seems to have two sides. One side claims that red wine consumption prevents cardiovascular disease, the second side claims that red wine consumption promotes cardiovascular disease. Each side of the controversy has a study that was conducted which supports it. The first study, Wine polyphenols decrease blood pressure, improve NO vasodialation and induce gene expression supports the side one of the controversy that red wine consumption
Red Wine and Cardiovascular Disease 2 prevents cardiovascular disease. The second study, Red Wine and Beer Elevate Blood Pressure in Normotensive Men, supports the side that red wine promotes cardiovascular disease. After both of these studies were examined, I found the strongest evidence and strongest study to support the side that red wine prevents cardiovascular disease. Discussion The first study supports the side that red wine improves cardiovascular health. The article is titled Wine polyphenols decrease blood pressure, improve NO vasodilatation and induce gene expression. The study was conducted because there were many suggestions that dietary factors, specifically polyphenols, that are in red wine might reduce the risk of cardiovascular disease (Andriantsitohania, et al). Previous animal studies have shown that taking red wine supplements with water prevents thrombosis in animals, but the supplements had no alcohol content. Therefore, with this evidence the researchers aim was to determine if the effects of short term oral administration of RWPCs (red wine poly phenols with alcohol) have an effect on vascular health (Andriantsitohania, et al.). This case control study included rats as their subjects. The rats were separated into three different cages with free access to their pellets for 7 days. The pellets were made
Red Wine and Cardiovascular Disease 3 with the same main ingredients, but each group received pellets that contained different percentages of polyphenols. The control group received a placebo of 5% glucose added to their pellets. Group 2 and three each received red wine polyphenols in their pellets. Group 2 received the red wine polyphenol Provinol and the third received the red wine poly phenol RWPC1. The systolic blood pressure and heart rate of all of the rats were measured daily. The results showed that the systolic blood pressure and heart rates of the rates receiving the placebo were no different from the beginning of the study versus at the end of the treatments. For the rats receiving the treatments of RWPCs in their pellets, SBP was not different at day 7. However, they did show a progressive decrease of SBP which was significantly different on days 4, 5 and 6 of the treatment compared to the rats who received the placebo. This study shos that when rats received RWPC from two different sources (Provinol and RWPC1) the arterial blood pressure decreased without changing the heart rate. Therefore, researchers concluded that RWPC treatment enhanced endotheliumdependent relaxation in response to acetylcholine but induced increased expression of COX-2 with subsequent increased release of endothelial thromboxane which opposed the
Red Wine and Cardiovascular Disease 4 NO-induced hyperactivity of the aorta to nor epinephrine (Andriantsitohaina, et al) all which increase the expression of inos which promotes vasodilatation. They found that this mechanism of RWPCs is what prevents cardiovascular disease. This study was strong because there were three different groups rats, one group given RWPC1, one group given Provinol, and one group a placebo of glucose. Because the study was done on rats, all other factors that may influence cardiovascular disease were controlled, such as total food intake, fat intake, daily exercise, etc. Also, since the study was done in vitro, the strong scientific evidence supports that red wine polyphenols promote vasodilatation from both of the RWPC sources. The weakness of this study is that it was done on rats. Therefore it is not onehundred percent clear that the results would be the same in humans. Also, the rats were all men, so it is unsure that the same effects would result in women rats as well. The second side of this controversy states that red wine promotes cardiovascular disease. This was supported by the study Red Wine and Beer Elevate Blood Pressure in Normotensive Men. The researchers believed that there was a positive relationship between alcohol consumption and blood pressure but they were not sure what kinds of alcohol were the culprits. The study aimed to find if red wine raises blood pressure because it has high
Red Wine and Cardiovascular Disease 5 antioxidant vasodilator polyphenolic compounds (Barden, A., et al), therefore promotinv cardiovascular disease. This was a cross over control study that occurred for 18 weeks in Australia which included 28 healthy men ages ranging from 20-65. They were selected based on being nonsmokers and normally consuming 43 +/- 10g of alcohol per day. The exclusion criteria included a BMI > 30, having cardiovascular disease, BP >160/90 and taking and kind of medications that could influence endothelial function. Since exclusion criteria included having cardiovascular disease, all participants began with normal heart health. All subjects were asked to not drink any alcohol for two weeks before the testing occurred. They were then randomly put into one of four groups using a number table. The first group was the control group which was to abstain from alcohol and grape precuts completely. The second group received 375 ml of red wine, the third group received this same type of red wine but it was dealcoholized, and the fourth group received a 3x375 ml can of Emu Bitter beer. The subjects were asked to consume their assigned intakes every day. Throughout the 18 week study, subjects were asked to eat the same as they would normally, but told to restrict tea intake to <2cups, avoid antioxidant supplements, avoid over the counter medications, and not consume other alcohol beside the alcohol provided.
Red Wine and Cardiovascular Disease 6 Each subject was telephoned every week to make sure that they were complying with what they were supposed to consume for the study. Measurements were taken at the end of weeks 2, 6, 10, 14 and 18. These measurements included 24 hour systolic and diastolic blood pressure, taken with a noninvasive devise to read 20 minutes while awake, and 30 minutes then calculated hourly blood pressure results. Subjects were also asked to document when they were awake or when they were sleeping during the measurements to estimate an average blood pressure twenty four hours. Endothelial function was assessed twice at the end of each intervention with an ultrasound. Urine was also collected to measure phenolic acids. 24 of the men completed the entire study which changed the age range to 39-65. The average BMI was now 25.3, and all regularly consumed 43+/-10g alcohol every day for 21 +/- years. Each man did a self-reported alcohol consumption during the study intervention study, and they reported non-authorized alcohol consumption 7 times. Results showed that 24-hr systolic blood pressure increased by 2.2 mmhg for those who consumed red wine and increased by 1.7 mmhg for those who consumed beer. Blood pressure and heart rate were not different between the control-abstinence and dealcholized wine groups. Diastolic blood pressure and heart rate were not different between any of the
Red Wine and Cardiovascular Disease 7 groups. Heart rate for those who consumed red wine and beer increased at 8-10 hours after drinking. There was no effect of red wine or beer on FMD. Strengths of this study were that there were three groups, one receiving a placebo and two receiving the alcohol. By having two different alcohols given, it can be concluded that if only one changes the outcomes that it is not solely based on the alcohol content of the drink. Weaknesses of the study are that it only included 24 people; all were men who drank alcohol daily. This means that they could have had un-diagnosed or unrecognizable cardiovascular problems before the study. Since the men were all different ages with a wide range of ages, the study didn t state which age of men had the change in blood pressure and heart rate. The changes in heart rate could have been more relevant with the older age groups than the younger ages. This study was not blind for the subjects nor the investigators, given the subjects were told what to drink. Having no blindness in the study may skew results. Also, compliance is very hard to measure by an over the phone interview, it is not known whether or not the subjects drank more than they reported to or less than what they were reported. This also may lead to skewed results. The diets each subject were most likely
Red Wine and Cardiovascular Disease 8 different from one another, those with higher blood pressure may have been consuming unhealthy foods and other factors that have to do with their diets that were not measured or taken into account. The study was very small and not over a long period of time so it is hard to make a strong conclusive statement for a big population on the recommendations for cardiovascular risk over time. Based on these major weaknesses to the study, I do not agree with it s results. Conclusion Based on the research I have done on the studies of red wine and cardiovascular health, moderate red wine consumption promotes cardiovascular health by increasing vasodilatation. Based on the first study done on rats, there were many strengths to that side such a having strong scientific evidence showing I all rats that blood pressure was lower. The second study had many major weaknesses which caused the results to be unreliable therefore was not a strong study. Further research that needs to be done includes studies that occur on both men and women. This way it can be measured whether or not red wine can improve cardiovascular health for the population as a whole. Another research to be done is to have studies of red wine intake down with controlled diet intakes. This will allow for less ability of a poor diet
Red Wine and Cardiovascular Disease 9 to skew the results in a negative way. Finally, have two groups of the study those with no family history of cardiovascular disease in one group and those with cardiovascular disease in another group. This cardiovascular disease prevention by red wine can be looked at for groups with or without family history of cardiovascular disease.
Red Wine and Cardiovascular Disease 10 References: Andriantsitohania, R., Bucher, B., Diebolt, M. Wine Polyphenols Decrease Blood Pressure, Improve NO Vasodilatation, and Induce Gene Expression. Journal of the American Heat Association. 2001. 38:159-165. Barden, A., Beilin, L., Burke, V., Hodgson, J., Puddey, I., Zilkens, R. Red Wine and Beer Elevate Blood Pressure in Normotensive Men. Journal of the American Heart Association. 2005. 45:874-879.