Heart conditions (CHD), as well as strokes, are the main causes of disability, death, and death in the developed nations 11. The majority of CHDs are caused by atherosclerosis, which is a degenerative condition of the arteries that is initiated by oxidative stress as well as chronic inflammation 2., 33. Smoking, arterial hypertension, hypercholesterolemia, diabetes mellitus, overweight/obesity, lack of physical activity, and genetic factors are known to play a role in determining cardiovascular risk . Although excessive alcohol intake is associated with the development of chronic diseases and other serious problems, a wealth of data from scientific evidence supports an inverse relationship between moderate alcohol consumption and the risk of CHD . The average consumption of alcohol is specified by the Dietary Guidelines for Americans 2015-2020 as one to one ounce of alcohol daily for women and up to the amount of two drinks a day for males . Several studies show that moderate consumption of alcohol is linked to an increase in cholesterol with a high density (HDL-C), less incidence of type 2 diabetes (T2D), and an improvement in the oxidative stress of lipids [7,8,9,1010,11,12]. These studies suggest that the consumption of red wine is more effective in preventing CHD compared to other alcohol-based beverages 1111. It is unclear if the beneficial effects for health associated with the consumption of red wines result solely from its alcohol content or additionally from the concerted influence of antioxidant compounds and alcohol apart from alcohol in red wine 1212. In addition to alcohol, red wine contains a wide range of active compounds–polyphenols–with antioxidant and anti-inflammatory properties that could contribute to protection from atherosclerotic pathologies . Light-moderate drinking of red wine has been proposed as a possible explanation for the epidemiological phenomenon known as the “French Paradox” , which indicates that the French population shows relatively lower CHD incidence/mortality rate compared with other Western people although their diets contain higher amounts of total fat and saturated fatty acids. The main objective of this review is to summarize the various red wine components and their cardioprotective potential. Additionally, we will review the theories of how they work and the chemical elements that affect the activity of the bioactive constituents of red wine. The results of all studies on the relationship between the consumption of red wine and CHD, published over the last ten years, are taken into consideration.
- Bioactive Components in Red Wine
Red wine contains high concentrations of polyphenolic compounds such as flavonoids (catechin, epicatechin, quercetin, anthocyanins, and procyanidins), resveratrol (3,5,4′-trihydroxystilbene), and polymeric tannins [ 15 ]. In general, the case of red wine is high in polyphenols and can be considered to be a significant polyphenols food source. It is a good source of polyphenols in the diet. 16 ]. There are phenolic substances in red wines appear to be essential as studies conducted by scientists have revealed that these metabolites are important and are the basis for beneficial biological effects, such as cardiovascular protection. 17, 18, 19 ].
The phenolic compounds of wine and grapes comprise three major groups: stilbenes and benzoic acids, cinnamic acid, Cinnamic acids, benzoic acids, and stilbenes. 20 ]. The second and third groups can be found in hydroxybenzoic as well as hydroxycinnamic acids. The benzoic acids can be found in grapes and oak wood. They, in storage, may migrate into wine. 21 ]. It is generally believed that this category of chemicals is found in red wine with concentrations that range from 60 to 566 mg/L.
2.1.1. Hydroxybenzoic Acids
Hydroxybenzoic acid (HBAs) are phenolic metabolites that have a general C6-C1 structure. Red wine is where the highest concentration of HBAs are gallic, p-hydroxybenzoic, and syringic. They are also known as gentisic, protocatechuic, and salicylic acids [ 22, 23 ]. As previously mentioned, the various hydroxybenzoic acids can occur in their undiluted forms 24 ]. Gallic acid plays a major role in HBA found in red wine but not in grapes, and it is likely to be formed through the hydrolysis from tannins (condensed and hydrolyzable) in the period of vesting in oak wood. 25 ]. The amount of hydroxybenzoic acids found in red wine is anticipated to be undetectable up to 218 mg/L, according to the data shown in Table 1 . Table 1. Principal representative groups of polyphenols are found in red wine 67, 68, 69, 77, 94, 95, 96 ].
2.1.2. Hydroxycinnamic Acids
Hydroxycinnamic acid is the most important phenol that is found in both grapes and wine. 26, 27 ]. Caffeic, coumaric, as well as ferrulic acids are among the most significant compounds within this sub-class of polyphenols 28 ]. Natural hydroxycinnamic acid is not found in grapes and appears in tartaric acid esters or diesters 29 ]. The primary hydroxycinnamic acid constituents of wine are tartaric, p-coumaric, and tartaric acids. 30 ]. The natural hydroxycinnamic acid exists in two forms. However, the trans-form is the one that is most abundant in both wine and grapes and wine. 31 ]. Coutaric acid is found primarily in the grape skin, while trans-caftaric acid and trans-tartaric acid are found mostly in the pulp 32 ]. It was found that the amount of hydroxycinnamic acid in red wines was determined to vary between 60 and 334 mg/L, as illustrated in Table 1.
Resveratrol (3 4, 5, trihydroxystilbene) is a non-flavonoid polyphenolic substance and has been identified as a well-known phytoalexin produced in response to the ravages of fungi and bacteria. 33 ]. It is found within more than 70 species of plants, which include peanuts, berries, cocoa, and grape skin 34 ]. Resveratrol contains two phenol rings that are linked to each other via the double bond of styrene in its chemical structure 35 ]. It can be found as cis (Z) or (E) trans(E) (E) isomers. Both are present in wine at varying levels 36, 37 ] that range from 0.1 up to 7 mg/L and between 0.7 up to 6.5 mg/L. 38 ]. The reason for this is the grape cultivar, geographical location, oenological practices, and wine type 39 ]. Several studies on the health benefits of trans-resveratrol for keeping human health in check and preventing many human ailments are available. 40, 41, 42, 43, 44, 45 ].
Magyar et al. [ 46] examined the cardioprotective effects of the low dose of resveratrol (10 mg/day) in 40 patients suffering from a stable artery. The results showed that resveratrol intake displayed a significantly lowered low-density lipoprotein-cholesterol (LDL-C) level, improved endothelial function and left ventricular diastolic function, and protected against some unfavorable hemorheological changes. Romain et al. [ 47] examined the benefits of a grapevine-shoot phenolic extraction (Vineatrol 30), which contained significant amounts of the resveratrol (about 15.2 percent) in the heart of the hamsters who ate a high-fat diet. The results revealed that Vineatrol 30 was able to reduce the formation of aortic fatty streaks by improving both anti-inflammatory and antioxidant activities. Fujitaka and Co. [ 48 The study examined the effects of an extremely very high dosage (100 mg/day) of modified resveratrol Longevinex in relation to the metabolism profile, inflammation response, and endothelial functions in patients suffering from metabolic syndrome (MetS). The results revealed that over three weeks, the modified resveratrol significantly improved endothelial functions of patients suffering from MetS.D’Archivio and co. [ 49 The study highlighted the potential influence of the content of sugar in the matrix on the bioavailability of resveratrol. Bioavailability is greater for the aglycone type in comparison to glycosides found in grape juice. Wang and co. [ 50 It was demonstrated that trans-resveratrol can be quickly metabolized via glucuronidation and the sulfation reaction and also by hydrogenation of the double bond, likely due to intestinal bacteria metabolism. Regarding its bioactivity, trans-resveratrol could be an interesting dietary supplement and is currently being proposed as a treatment for a variety of diseases.