BEYOND ALCOHOL - BEVERAGE CONSUMPTION AND CARDIOVASCULAR MORTALITY

This paper reviews epidemiological investigations which have identifie d an inverse relationship between alcohol consumption and death from c oronary heart disease: evidence from studies of mixed populations as w ell as of single-sex populations have, on the whole, demonstrated that this relationship is independent of sex or age. This 'cardioprotectiv e effect' of alcohol can be explained, at least in part, by ethanol-re lated increases in high density lipoprotein cholesterol and reduced pl atelet coagulability. With certain beverages, especially red wine, phe nolic compounds may provide additional protection by altering eicosano id metabolism in favour of increased prostacyclin and decreased thromb oxane synthesis, as well as antioxidant functions which prevent the pe roxidation of low-density lipoprotein. Trans-resveratrol, a tri-hydrox y stilbene present in the skins of specific grape cultivars, is a cons tituent of certain red wines which may play a crucial role in modulati ng lipoprotein metabolism, eicosanoid synthesis, oxidation and coagula tion. Preliminary studies using the human hepatoma cell line HepG2 are described, demonstrating that this compound has no effect upon cell v iability or overall protein synthesis in these cells, and at high conc entrations DNA synthesis as measured by radioactive thymidine incorpor ation is enhanced. Reduced intracellular concentration and secretion o f apolipoprotein B have been shown to occur in response to resveratrol although a clear dose-dependency has not yet been demonstrated. The m echanisms underlying these changes as well as the effects upon the syn thesis and secretion of other apolipoproteins are under active investi gation in our laboratory.