The relationship between alcohol consumption and incident ischemic heart disease and stroke is characterized by a J- or U-shape. This denotes that light drinking has a preventive effect on cardiovascular diseases. Effects of alcohol drinking on lipid metabolism including an increase in HDL cholesterol concentration and a decrease in LDL cholesterol concentration are the main reasons for the anti-atherosclerotic action of alcohol. The antithrombotic effect of alcohol through the inhibition of platelet function is also involved in the lower incidence of ischemic arterial disease in drinkers. Capacitative Ca entry, a main mechanism for platelet aggregation, is inhibited by ethanol. Ethanol also inhibits plasmalemmal phospholipase A activity and consequent thromboxane A production. French paradox is a phenomenon showing the merit of red wine consumption for the prevention of ischemic heart disease. In addition to ethanol, red wine contains anti-oxidative polyphenol compounds, represented by resveratrol, which has an antiplatelet action. Resveratrol also inhibits the capacitative Ca entry in platelets. Furthermore, ethanol and resveratrol show a synergic inhibitory action on platelet aggregation, which may be caused by the reduction in the Ca sensitivity of the contractile apparatus of platelets and the attenuation of COX-1 activity. Thus, the strength of the antithrombotic action is thought to differ depending on alcohol beverage. Decreases in concentrations of coagulation factors including fibrinogen are also involved in the alcohol-induced antithrombotic action. Alcohol drinking causes hemorrhagic diathesis as well as antithrombotic tendency.
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