Purple Grape Juice Improves Endothelial Function and Reduces the Susceptibility of LDL Cholesterol to Oxidation in Patients With Coronary Artery Disease

James H. Stein, MD; Jon G. Keevil, MD; Donald A. Wiebe, MD; Susan Aeschlimann, RDMS, RVT; John D. Folts, PhD From the University of Wisconsin Medical School, Madison.

Correspondence and reprint requests to James H. Stein, MD, Section of Cardiology, University of Wisconsin Medical School, 600 Highland Avenue, H6/315 CSC, Madison, WI 53792-3982.


Background—In vitro, the flavonoid components of red wine and purple grape juice are powerful antioxidants that induce endothelium-dependent vasodilation of vascular rings derived from rat aortas and human coronary arteries. Although improved endothelial function and inhibition of LDL oxidation may be potential mechanisms by which red wine and flavonoids reduce cardiovascular risk, the in vivo effects of grape products on endothelial function and LDL oxidation have not been investigated. This study assessed the effects of ingesting purple grape juice on endothelial function and LDL susceptibility to oxidation in patients with coronary artery disease (CAD).

Methods and Results—Fifteen adults with angiographically documented CAD ingested 7.7±1.2 mL · kg-1 · d-1 of purple grape juice for 14 days. Flow-mediated vasodilation (FMD) was measured using high-resolution brachial artery ultrasonography. Susceptibility of LDL particles to oxidation was determined from the rate of conjugated diene formation after exposure to copper chloride. At baseline, FMD was impaired (2.2±2.9%). After ingestion of grape juice, FMD increased to 6.4±4.7% (P=0.003). In a linear regression model that included age, artery diameter, lipid values, and use of lipid-lowering and antioxidant therapies, the effect of grape juice on FMD remained significant (mean change 4.2±4.4%, P<0.001). After ingestion of grape juice, lag time increased by 34.5% (P=0.015).

Conclusions—Short-term ingestion of purple grape juice improves FMD and reduces LDL susceptibility to oxidation in CAD patients. Improved endothelium-dependent vasodilation and prevention of LDL oxidation are potential mechanisms by which flavonoids in purple grape products may prevent cardiovascular events, independent of alcohol content.

Key Words: antioxidants • arteries • coronary disease • endothelium
(Circulation. 1999;100:1050-1055.) © 1999 American Heart Association, Inc.