Myocardial infarction remains the leading cause of death in most developed countries. However, the French population somehow appears to be protected from such heart attacks, as cardiovascular risk is reduced by approximately 50% when compared to the rest of the Western world. While this phenomenon – termed the “French Paradox” – cannot be attributed to traditional cardio­vascular risk factors such as smoking, high blood pressure, high cholesterol, diabetes and obesity, epidemiological studies have indicated that it is the wine that protects the French from heart attacks. Further studies suggested that red wine may confer significant advantages over white wine in respect to cardio­vascular health.

Wine is more protective against atherosclerosis than other alcoholic beverages
It is well established that the risk of dying from a heart attack increases with the presence and severity of traditional vascular risk factors such as smoking, hypertension, high cholesterol, diabetes, and obesity. A study that was published by Renaud & De Lorgeril in The Lancet more than ten years ago related the intake of saturated fats to cardiovascular mortality in a number of industrialized countries. The results of this study were intriguing: as expected, there was a positive correlation between cholesterol intake and the probability to die from a heart attack in most countries. However, compared to other countries with similar fat intake, the risk of myocardial infarction was approximately 50% lower in France, whereas it was significantly higher in the UK (Fig. 1).

When the data were corrected for the wine consumption in each country, the differences were no longer apparent. This phenomenon, which was termed the “French paradox”, has led to the hypothesis that the regular drinking of wine may somehow protect from atherosclerotic vascular disease and its consequences such as myocardial infarction and stroke.

Since more than one hundred years, a large number of epidemiologic studies have concluded that moderate alcohol consumption (1-3 drinks per day) is associated with a reduced risk of complications secondary to atherosclerosis, namely heart attack and stroke. However, these data do not provide an explanation for the observation of Renaud & De Lorgeril as the amount of total alcohol consumption was similar in the various countries. The French consume alcohol mostly in form of wine. When the differential effects of various alcoholic beverages were evaluated, a number of studies have consistently shown that in comparison to spirits, beer and white wine, red wine is the most beneficial in reducing the risks of heart vessel disease and mortality in general. We have now begun to understand why red wine is more beneficial than white wine and other alcoholic beverages, as researchers have identified beneficial effects of non-alcoholic substances present in red wine on the cellular and molecular level.