MODULATION OF COAGULATION AND PLATELET FUNCTION WITH RED WINE: INSIGHTS FROM CLINICAL EVIDENCE

Background and Aims

Understanding the relationship between diet and cardiovascular health, particularly the effects of red wine (RW), on coagulation and platelet function, is critical in elucidating its role in preventing thrombosis and atherosclerosis.

Methods

A comprehensive review of 20 clinical studies was conducted, focusing on the effects of RW consumption on coagulation markers such as prothrombin fragments (n=7), activated factor VII (n=5), fibrinogen levels (n=8), and platelet aggregation (n=10). The review included studies with sample sizes ranging from 30 to 200 participants and RW intake varying from 1 to 3 glasses per day over periods of 2 weeks to 6 months.

Results

The findings indicate a trend towards decreased thrombotic and platelet activation and reduced plasma viscosity. Studies showed reduced thrombotic and platelet activation, decreases in PAI-1 and platelet aggregation, and increased FMD and nitric oxide levels. Some reported no change in carotid plaque volume, endothelial function, fibrinogen, or D-dimer levels. Others observed increased arterial stiffness, improved vasodilation post-smoking, and beneficial changes in atherosclerosis-related gene expression. However, there were mixed results on bleeding time and left ventricular function.

Conclusions

While research indicates that RW consumption can lead to reduced thrombotic and platelet activation, decreased plasma viscosity, improved endothelial function, and reduced arterial stiffness, these potential cardiovascular benefits are overshadowed by the broader health risks associated with alcohol consumption. The evidence is not uniform, with some studies reporting no impact on variables such as bleeding time, carotid plaque volume, or fibrinogen levels. These findings underscore the complexity of RW's effects on health. Due to the significant health risks linked to alcohol intake, including addiction, liver disease, and increased cancer risk, the use of RW as a strategy for increasing cardiovascular health cannot be recommended.