The idea that wine is good for the heart sounds too good to be true, and scientifically, it might be. As of 2022, cardiovascular disease was the second leading cause of death in Canada, just after cancer (Public Health Agency of Canada 2017). The build-up of plaque inside arteries, or atherosclerosis, is a main underlying cause of these diseases (Libby et al. 2019). The plaque hardens over time, leading to the narrowing of arteries, making it more difficult for blood to flow to vital organs. 

The idea that red wine has these health benefits stems from the “French Paradox.” Researchers noticed that populations that consumed more wine had lower rates of heart disease, despite having diets high in saturated fats, which typically contribute to heart disease (Renaud and De Lorgeril 1992). This brought forth the idea that resveratrol might limit the oxidative damage and inflammation related to heart disease. 

There has been a long-standing debate on the possibility of wine, especially red wine, having anti-atherosclerotic effects. Red wine’s supposed health benefits come from polyphenols, natural compounds which are produced during grape fermentation and aging (Buljeta et al. 2023). A key polyphenol is resveratrol, an antioxidant and anti-inflammatory agent (Prasad 2012). As an antioxidant, resveratrol works to neutralize harmful particles in the body, called free radicals; these unstable molecules damage cell membranes, DNA, and lipids in artery walls. 

Understanding the potential benefits of red wine requires examining the processes that occur within arteries. Resveratrol has been shown to reduce oxidative stress, suppress inflammation, and improve endothelial function (Prasad 2012). These mechanisms overlap with early events of atherosclerosis, which begins when low-density lipoproteins enter the arterial wall and undergo oxidation (Libby et al. 2019) (Figure 1). Oxidized lipoproteins trigger the recruitment of immune cells called macrophages, which attempt to clear the lipoproteins. However, the macrophages become overloaded and form foam cells, which are the precursors to plaque. By targeting oxidative stress and inflammation, resveratrol could theoretically slow this plaque-forming process (Libby et al. 2019).

Evidence from human studies is less convincing. Observational studies showed a small relationship between those who report regular red wine consumption and lower rates of cardiovascular disease; however, this could also be attributed to lifestyle and genetic factors rather than the wine itself (Mukamal et al. 2010). There is no direct evidence that wine or resveratrol prevents atherosclerosis. Additionally, resveratrol content in wine is small; the concentrations of resveratrol used in studies are much higher than what one could obtain from drinking red wine, thus the observed benefits would also be greatly reduced (Goldberg et al. 2003). Factors such as genetic predisposition, cholesterol levels, and lysosomal function in immune cells likely play a larger role in determining plaque buildup (Khera et al. 2016; Bonacina et al. 2025). Focusing on exercise, a balanced diet, and managing blood pressure and cholesterol levels remains more important in preventing atherosclerosis.

While some people associate red wine with heart health, it is important to remember that it is not a quick fix for heart disease. There are a multitude of factors which contribute to preventing heart disease, with wine consumption only playing a small role. Wine should be enjoyed for taste, not treatment!

References

Bonacina, Fabrizia, Xiangyu Zhang, Nicolas Manel, Laurent Yvan-Charvet, Babak Razani, and Giuseppe D. Norata. 2025. “Lysosomes in the Immunometabolic Reprogramming of Immune Cells in Atherosclerosis.” Nature Reviews Cardiology 22 (3): 149–64. https://doi.org/10.1038/s41569-024-01072-4. 

Buljeta, Ivana, Anita Pichler, Josip Šimunović, and Mirela Kopjar. 2023. “Beneficial Effects of Red Wine Polyphenols on Human Health: Comprehensive Review.” Current Issues in Molecular Biology 45 (2): 782–98. https://doi.org/10.3390/cimb45020052. 

Goldberg, David M., Joseph Yan, and George J. Soleas. 2003. “Absorption of Three Wine-Related Polyphenols in Three Different Matrices by Healthy Subjects.” Clinical Biochemistry 36 (1): 79–87. https://doi.org/10.1016/s0009-9120(02)00397-1. 

Khera, Amit V., Connor A. Emdin, Isabel Drake, et al. 2016. “Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease.” New England Journal of Medicine 375 (24): 2349–58. https://doi.org/10.1056/NEJMoa1605086. 

Libby, Peter, Julie E. Buring, Lina Badimon, et al. 2019. “Atherosclerosis.” Nature Reviews Disease Primers 5 (1): 56. https://doi.org/10.1038/s41572-019-0106-z. 

Mukamal, Kenneth J., Chiung M. Chen, Sowmya R. Rao, and Rosalind A. Breslow. 2010. “Alcohol Consumption and Cardiovascular Mortality among U.S. Adults, 1987 to 2002.” Journal of the American College of Cardiology 55 (13): 1328–35. https://doi.org/10.1016/j.jacc.2009.10.056. 

Prasad, Kailash. 2012. “Resveratrol, Wine, and Atherosclerosis.” The International Journal of Angiology : Official Publication of the International College of Angiology, Inc 21 (1): 7–18. https://doi.org/10.1055/s-0032-1306417. 

Public Health Agency of Canada. 2017. “Heart Disease in Canada: Highlights from the Canadian Chronic Disease Surveillance System, 2017.” Education and awareness. August 22. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada-fact-sheet.html. 

Renaud, S., and M. De Lorgeril. 1992. “Wine, Alcohol, Platelets, and the French Paradox for Coronary Heart Disease.” The Lancet 339 (8808): 1523–26. https://doi.org/10.1016/0140-6736(92)91277-F.