Urinary Biomarker confirms CV benefit with Moderate wine intake: PREDIMED Trial

"Drinking 12-35 glasses of wine per month was associated with a lower risk of combined heart failure, myocardial infarction, stroke, and cardiovascular death over a median follow-up of nine years," the researchers reported. This finding aligns with prior epidemiological research suggesting cardiovascular benefits from moderate wine consumption.

To ensure accurate measurement of wine intake, the researchers used tartaric acid as a surrogate marker, given its specificity to grapes and the limited consumption of alternative dietary sources.

Previous studies have linked moderate wine consumption to a reduced risk of cardiovascular disease (CVD) in older populations. However, self-reported wine consumption is often subject to measurement errors due to its reliance on subjective assessments. To address this, Inés Domínguez-López, Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain, and colleagues sought to examine the relationship between urinary tartaric acid—an objective biomarker of wine intake—and the incidence of composite clinical CVD events.

For this purpose, the researchers designed a case-cohort study nested within the PREDIMED trial, involving 1,232 participants: 685 incident cases of CVD and a random subcohort of 625 participants, with 78 overlapping cases. Wine consumption was evaluated using validated food frequency questionnaires, while urinary tartaric acid levels were measured at baseline and after one year of intervention using liquid chromatography-tandem mass spectrometry. Weighted Cox regression models were employed to estimate CVD hazard ratios (HRs).

The investigation uncovered the following findings:

• Tartaric acid showed a moderate correlation with self-reported wine consumption at baseline [r = 0.46].
• Five post hoc categories of urinary tartaric acid excretion were used to better represent risk patterns.
• Urinary tartaric acid concentrations of 3–12 μg/mL and 12–35 μg/mL, reflecting approximately 3–12 and 12–35 glasses of wine per month, were linked to lower CVD risk [HR 0.62 and HR 0.50, respectively].
• Associations between self-reported wine consumption and CVD risk were less pronounced.

"Using an objective and reliable urinary biomarker, we found that light-to-moderate wine consumption was linked to a reduced incidence of clinical cardiovascular events in a Mediterranean population at high cardiovascular risk," the researchers wrote.

The study authors, however, noted that their findings might not be applied to populations outside the older, Mediterranean PREDIMED cohort. Despite efforts to adjust for confounding factors, the study's observational nature leaves the possibility of residual confounding.

They acknowledged that the exact mechanisms behind wine's cardiovascular benefits remain unclear but suggested that polyphenols might play a significant role. "Polyphenols offer various health benefits, including anti-inflammatory effects, which could contribute to the cardioprotective properties of wine," they wrote, adding that "multiple mechanisms may underlie these cardioprotective effects."

Reference:

M, R., Razquin, C., Galkina, P., M, Á., Fitó, M., Fiol, M., Lapetra, J., Sorlí, J. V., Castañer, O., Liang, L., Hu, F. B., Ros, E., Ángel, M., & Estruch, R. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: The PREDIMED trial. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae804