Alcohol,Wine,andCardiovascularDisease

Acuteintoxication
Intoxicationisaconditionthatfollowstheadministrationofapsychoactivesubstance
andresultsindisturbancesinthelevelofconsciousness,cognition,perception,
judgment,affect,orbehavior,orotherpsychophysiologicalfunctionsandresponses.
Alcoholdependence
Substancerelateddisorderinwhichanindividualisaddictedtoalcoholeither
physicallyormentally,andcontinuestousealcoholdespitesignificantareasof
dysfunction,evidenceofphysicaldependence,and/orrelatedhardship.
Cirrhosis
Consequenceofchronicliverdiseasecharacterizedbyreplacementoflivertissueby
fibrosis,scartissueandregenerativenodules(lumpsthatoccurasaresultofaprocess
inwhichdamagedtissueisregenerated),leadingtolossofliverfunction.Cirrhosisis
mostcommonlycausedbyalcoholism,hepatitisBandhepatitisC,andfattyliver
disease,buthasmanyotherpossiblecauses.Somecasesareidiopathic(i.e.,of
unknowncause).
Pancreatitis
Aninflammationofthepancreas.Ithasseveralcausesandsymptomsandrequires
immediatemedicalattention.Itoccurswhenpancreaticenzymes(especiallytrypsin)
thatdigestfoodareactivatedinthepancreasinsteadofthesmallintestine.Itmaybe
acutebeginningsuddenlyandlastingafewdays,orchronicoccurringovermany
years.
Hypertension
Achronicmedicalconditioninwhichthebloodpressureinthearteriesiselevated.
Thisrequiresthehearttoworkharderthannormaltocirculatebloodthroughthe
bloodvessels.Bloodpressureissummarizedbytwomeasurements,systolicand
diastolic,whichdependonwhethertheheartmuscleiscontracting(systole)or
relaxedbetweenbeats(diastole)andequatetoamaximumandminimumpressure,
respectively.Normalbloodpressureatrestiswithintherangeof100140mmHg
systolic(topreading)and6090mmHgdiastolic(bottomreading).Highblood
pressureissaidtobepresentifitispersistentlyatorabove140/90mmHg.
Stroke
Astroke,sometimesreferredtobytheoldertermcerebrovascularaccident(CVA),is
therapidlossofbrainfunctionduetodisturbanceinthebloodsupplytothebrain.
Thiscanbeduetoischemia(lackofbloodflow)causedbyblockage(thrombosis,
arterialembolism),orahemorrhage.Asaresult,theaffectedareaofthebraincannot

function,whichmightresultinaninabilitytomoveoneormorelimbsononesideof
thebody,inabilitytounderstandorformulatespeech,oraninabilitytoseeonesideof
thevisualfield.
DilatedCardiomyopathy
DilatedcardiomyopathyorDCMisaconditioninwhichtheheartbecomesweakened
andenlargedandcannotpumpbloodefficiently.Thedecreasedheartfunctioncan
affectthelungs,liver,andotherbodysystems.DCMisoneofthecardiomyopathies,
agroupofdiseasesthatprimarilyaffectthemyocardium(themuscleoftheheart).
Differentcardiomyopathieshavedifferentcausesandaffecttheheartindifferent
ways.InDCMaportionofthemyocardiumisdilated,oftenwithoutanyobvious
cause.Leftorrightventricularsystolicpumpfunctionoftheheartisimpaired,leading
toprogressivecardiacenlargementandhypertrophy,aprocesscalledremodeling.
CardiacArrhythmia
Cardiacdysrhythmia(alsoknownasarrhythmiaorirregularheartbeat)isanyofa
largeandheterogeneousgroupofconditionsinwhichthereisabnormalelectrical
activityintheheart.Theheartbeatmaybetoofastortooslow,andmayberegularor
irregular.Aheartbeatthatistoofastiscalledtachycardiaandaheartbeatthatistoo
slowiscalledbradycardia.Althoughmanyarrhythmiasarenotlifethreatening,some
cancausecardiacarrest
Atherosclerosis/Atherothrombotic
Atherosclerosis(alsoknownasarterioscleroticvasculardiseaseorASVD)isa
specificformofarteriosclerosisinwhichanarterywallthickensasaresultofthe
accumulationoffattymaterialssuchascholesterolandtriglyceride.Itisasyndrome
affectingarterialbloodvessels,achronicinflammatoryresponseinthewallsof
arteries,causedlargelybytheaccumulationofmacrophagesandwhitebloodcells
andpromotedbylowdensitylipoproteins(LDL,plasmaproteinsthatcarry
cholesterolandtriglycerides)withoutadequateremovaloffatsandcholesterolfrom
themacrophagesbyfunctionalhighdensitylipoproteins(HDL)(seeapoA1Milano).
Itiscommonlyreferredtoasahardeningorfurringofthearteries.Itiscausedbythe
formationofmultipleplaqueswithinthearteries.
Metaanalysis
Instatistics,ametaanalysisreferstomethodsfocusedoncontrastingandcombining
resultsfromdifferentstudies,inthehopeofidentifyingpatternsamongstudyresults,
sourcesofdisagreementamongthoseresults,orotherinterestingrelationshipsthat
maycometolightinthecontextofmultiplestudies.Initssimplestform,thisis

normallybyidentificationofacommonmeasureofeffectsize,ofwhichaweighted
averagemightbetheoutputofametaanalysis.Theweightingmightberelatedto
samplesizeswithintheindividualstudies.Moregenerallythereareotherdifferences
betweenthestudiesthatneedtobeallowedfor,butthegeneralaimofametaanalysis
istomorepowerfullyestimatethetrueeffectsizeasopposedtoalesspreciseeffect
sizederivedinasinglestudyunderagivensinglesetofassumptionsandconditions.
SelfreportStudy
Aselfreportstudyisatypeofsurvey,questionnaire,orpollinwhichrespondents
readthequestionandselectaresponsebythemselveswithoutresearcherinterference.
Aselfreportisanymethod,whichinvolvesaskingaparticipantabouttheirfeelings,
attitudes,beliefsandsoon.Examplesofselfreportsarequestionnairesand
interviews;selfreportsareoftenusedasawayofgainingparticipants'responsesin
observationalstudiesandexperiments.Selfreportstudieshavevalidityproblems.
Patientsmayexaggeratesymptomsinordertomaketheirsituationseemworse,or
theymayunderreporttheseverityorfrequencyofsymptomsinordertominimize
theirproblems.Patientsmightalsosimplybemistakenormisrememberthematerial
coveredbythesurvey.
CoronaryHeartDisease
Coronaryarterydisease(CAD)alsoknownasatheroscleroticheartdisease,coronary
heartdisease,orischemicheartdisease(IHD),isthemostcommontypeofheart
diseaseandcauseofheartattacks.Thediseaseiscausedbyplaquebuildingupalong
theinnerwallsofthearteriesoftheheart,whichnarrowsthearteriesandreduces
bloodflowtotheheart.
IschemicStroke
Ischemic(isskeemic)strokeoccurswhenanarterytothebrainisblocked.The
braindependsonitsarteriestobringfreshbloodfromtheheartandlungs.Theblood
carriesoxygenandnutrientstothebrain,andtakesawaycarbondioxideandcellular
waste.Ifanarteryisblocked,thebraincells(neurons)cannotmakeenoughenergy
andwilleventuallystopworking.Ifthearteryremainsblockedformorethanafew
minutes,thebraincellsmaydie.Thisiswhyimmediatemedicaltreatmentiscritical.
Peripheral Arterial Disease
Peripheralarterialdisease(P.A.D.)isadiseaseinwhichplaque(plak)buildsupinthe
arteriesthatcarrybloodtoyourhead,organs,andlimbs.Plaqueismadeupoffat,
cholesterol,calcium,fibroustissue,andothersubstancesintheblood.

CongestiveHeartFailure
Heartfailure(HF),oftencalledcongestiveheartfailure(CHF)orcongestivecardiac
failure(CCF),occurswhentheheartisunabletoprovidesufficientpumpactionto
maintainbloodflowtomeettheneedsofthebody.Heartfailurecancauseanumber
ofsymptomsincludingshortnessofbreath,legswelling,andexerciseintolerance.The
conditionisdiagnosedbypatientphysicalexaminationandconfirmedwith
echocardiography.Bloodtestshelptodeterminethecause.Treatmentdependson
severityandcauseofheartfailure.Inachronicpatientalreadyinastablesituation,
treatmentcommonlyconsistsoflifestylemeasuressuchassmokingcessation,light
exercise,dietarychanges,andmedications.Sometimes,dependingfrometiology,itis
treatedwithimplanteddevices(pacemakersorventricularassistdevices)and
occasionallyahearttransplantisrequired.
Platelet
Platelets,orthrombocytes(fromGreek,"clot"and,"cell"),aresmall,
diskshapedclearcellfragments(i.e.cellsthatdonothaveanucleus),23min
diameter,whicharederivedfromfragmentationofprecursormegakaryocytes.The
averagelifespanofaplateletisnormallyjust5to9days.Plateletsareanaturalsource
ofgrowthfactors.Theycirculateinthebloodofmammalsandareinvolvedin
hemostasis,leadingtotheformationofbloodclots.
Ifthenumberofplateletsistoolow,excessivebleedingcanoccur.However,ifthe
numberofplateletsistoohigh,bloodclotscanform(thrombosis),whichmay
obstructbloodvesselsandresultinsucheventsasastroke,myocardialinfarction,
pulmonaryembolismortheblockageofbloodvesselstootherpartsofthebody,such
astheextremitiesofthearmsorlegs.Anabnormalityordiseaseoftheplateletsis
calledathrombocytopathy,whichcouldbeeitheralownumberofplatelets

(thrombocytopenia),adecreaseinfunctionofplatelets(thrombasthenia),oran
increaseinthenumberofplatelets(thrombocytosis).Therearedisordersthatreduce
thenumberofplatelets,suchasheparininducedthrombocytopenia(HIT)or
thromboticthrombocytopenicpurpura(TTP)thattypicallycausethromboses,orclots,
insteadofbleeding.
Coagulation
Coagulation(thrombogenesis)istheprocessbywhichbloodformsclots.Itisan
importantpartofhemostasis,thecessationofbloodlossfromadamagedvessel,
whereinadamagedbloodvesselwalliscoveredbyaplateletandfibrincontaining
clottostopbleedingandbeginrepairofthedamagedvessel.Disordersofcoagulation
canleadtoanincreasedriskofbleeding(hemorrhage)orobstructiveclotting
(thrombosis)
FibrinogenRoleinCoagulation
Fibrinogen(clottingfactorI)issynthesizedintheliverandplaysacriticalroleinthe
hemostaticprocess.Fibrinogenpromotesplateletaggregationbystimulatingplatelet
clumping.Solublefibrinogenalsoconvertstoinsolublefibrin,whichiscrosslinked
toformameshlikenetwork.
Thecrosslinkedfibrinistheculminationofthecoagulationcascade.Thefibrinmesh
trapsredbloodcellsandplateletsandeventuallyformsastablebloodclot.
Thefibrinmeshisresponsiblefor:

Providingtensilestrength
Ensuringstabilityoftheinitiallylooseplateletplug
Mechanicallyimpedingbloodlossatthesitesofbloodvesselinjury
Providingstructuretothevesselwall
BloodClot
Athrombus(Greek:),orbloodclot,isthefinalproductoftheblood
coagulationstepinhemostasis.Itisachievedviatheaggregationofplateletsthatform
aplateletplug,andtheactivationofthehumoralcoagulationsystem(i.e.clotting
factors).Athrombusisnormalincasesofinjury,butpathologicininstancesof
thrombosis.
InsulinSensitivity
Insulinsensitivityisageneralphenomenainthebody,andcanbemeasuredafew
waysthroughstudies.Thepancreas(anorganthatregulatesbloodsugar)secretes
insulininresponsetohighbloodsugar,andcells(likemuscleorfatcells)canabsorb
bloodsugarwhenstimulatedbyinsulin.Insulinsensitivityistherelationshipbetween
howmuchinsulinneedstobeproducedinordertodepositacertainamountof
glucose.Youareinsulinsensitiveifasmallamountofinsulinneedstobesecretedto

depositacertainamountofglucose,andinsulinresistantifalotofinsulinneedstobe
secretedtodepositthesameamountofglucose.

HighDensityLipoprotein
Highdensitylipoprotein(HDL)isoneofthefivemajorgroupsoflipoproteins,
which,inorderofsize,largesttosmallest,arechylomicrons,VLDL,IDL,LDL,and
HDL,whichenablethetransportationoflipids(fats),suchascholesteroland
triglycerides,withinthewateraroundcells,includingthebloodstream.
MillionWomanStudy
TheMillionWomenStudyisanationalstudyofwomenshealth,involvingmorethan
onemillionUKwomenaged50andover.ItisacollaborativeprojectbetweenCancer
ResearchUKandtheNationalHealthService,withadditionalfundingfromthe
MedicalResearchCouncilandtheHealthandSafetyExecutive,whichaimsto
answermanyoutstandingquestionsaboutthefactorsaffectingwomenshealthinthis
agegroup.Themainfocusofthestudyrelatestotheeffectsofhormonereplacement
therapyuse,butthelargesizeofthestudymeansthataverybroadrangeofhealth
issuescanbeaddressed.Between1996and2001,womenwereinvitedtojointhe
MillionWomenStudywhentheyreceivedtheirinvitationtoattendbreastscreeningat
oneof66participatingNHSBreastScreeningCentresintheUK.Atthesecentres,
womenreceivedastudyquestionnairewiththeirinvitation,whichtheywereaskedto
completeandreturnatthetimeofscreening.Around70%ofthoseattendingthe
programmereturnedquestionnairesandagreedtotakepartinthestudythis
excellentresponsemeansthatover1in4womenintheUKinthetargetagegroupare
nowparticipatinginthestudy.ItalsomeansthattheMillionWomenStudyisthe
largeststudyofitskindintheworld.
Resveratrol
Resveratrol(3,5,4'trihydroxytransstilbene)isastilbenoid,atypeofnaturalphenol,
andaphytoalexinproducednaturallybyseveralplantsespeciallytherootsofthe
JapaneseKnotweed,fromwhichitisextractedcommerciallywhenunderattackby
pathogenssuchasbacteriaorfungi.Theeffectsofresveratrolarecurrentlyatopicof
numerousanimalandhumanstudies.Despitethemainstreampressalleging
resveratrol'santiagingeffects,asof2013therewasnoaccepteddatatoforma
scientificbasisfortheapplicationoftheseclaimstomammals.Aseriesofearly
reportsfoundthatitincreasedthelifespanofmodelorganisms.Severalscientists
involvedinthesestudieswentontofoundSirtrisPharmaceuticals,acompany
workingtodevelopresveratrolanalogsasproprietarydrugs.Howeversubsequent
independentresearchhasfailedtoreplicatetheseresults.Inmouseandrat
experiments,antiinflammatory,bloodsugarloweringandotherbeneficial
cardiovasculareffectsofresveratrolhavebeenreported;however,inevery
experimenttodate,resveratrolhasfailedtoextendthelifespanoflean,genetically

normalmiceorrats.Limitedhumanclinicaltrialshavebeencompleted.Whilethe
reportedeffectsareoftenpositive,resveratrolmayhavelesserbenefitsinhumans.At
present,researchonresveratrolisstillinitsinfancyandthelongtermeffectsof
supplementationinhumansarenotknown.
Resveratrolhasgainedalotofattentionforitsreportedantiaginganddisease
combatingbenefits.Earlyresearch,mostlydoneintesttubesandinanimals,suggests
thatresveratrolmighthelpprotectthebodyagainstanumberofdiseases,including:
Heartdisease.Resveratrolhelpsreduceinflammation,preventstheoxidationofLDL
"bad"cholesterol,andmakesitmoredifficultforplateletstosticktogetherandform
theclotsthatcanleadtoaheartattack.
Cancer.Resveratrolisthoughttolimitthespreadofcancercellsandtriggerthe
processofcancercelldeath(apoptosis).
Alzheimer'sdisease.Resveratrolmayprotectnervecellsfromdamageandthebuildup
ofplaquethatcanleadtoAlzheimer's.
Diabetes.Resveratrolhelpspreventinsulinresistance,aconditioninwhichthebody
becomeslesssensitivetotheeffectsofthebloodsugarloweringhormone,insulin.
Insulinresistanceisaprecursortodiabetes.
FrenchParadox
TheFrenchparadoxisthecatchphrasefrequentlyusedtosummarizetheapparently
paradoxicalepidemiologicalobservationthatFrenchpeoplehavearelativelylow
incidenceofcoronaryheartdisease(CHD),despitehavingadietrelativelyrichin
saturatedfats,[1]inapparentcontradictiontothewidelyheldbeliefthatthehigh
consumptionofsuchfatsisariskfactorforCHD.Theparadoxisthatifthethesis
linkingsaturatedfatstoCHDisvalid,theFrenchoughttohaveahigherrateofCHD
thancomparablecountrieswherethepercapitaconsumptionofsuchfatsislower.
EndothelialDysfunction
Inhumanvasculardiseases,endothelialdysfunctionisasystemicpathologicalstateof
theendothelium(theinnerliningofbloodvessels)andcanbebroadlydefinedasan
imbalancebetweenvasodilatingandvasoconstrictingsubstancesproducedby(or
actingon)theendothelium.[1]Normalfunctionsofendothelialcellsinclude
mediationofcoagulation,plateletadhesion,immunefunctionandcontrolofvolume
andelectrolytecontentoftheintravascularandextravascularspaces.