Red wine contains many compounds that may have therapeutic use, including 
resveratrol (3,4',5-trihydroxytrans-stilbene). Since resveratrol could be 
administered both in the diet and as a therapeutic agent, defining appropriate 
concentrations requires understanding of the pharmacokinetics. Resveratrol 
absorption is rapid but plasma concentrations are low as it is rapidly and 
efficiently converted into relatively hydrophilic phase-2 conjugates, and 
metabolites, which are then rapidly excreted via the urine and bile. Resveratrol 
is an effective antioxidant in vivo by increasing NO synthesis and also 
maintaining the reduced intracellular redox state via the thioredoxin system. 
Further, activation of sirtuins (one class of lysine deacetylases) may mediate 
the cardiovascular responses shown by resveratrol. Studies on animal models of 
human disease suggest that resveratrol has the potential to decrease 
cardiovascular symptoms in patients with myocardial infarction, arrhythmias, 
hypertension, cardiomyopathies, fibrosis, atherosclerosis, thrombosis and 
diabetes, but, as yet, human clinical trials are rare. Cardioprotection by 
resveratrol in rodent models may rely on mechanisms producing pharmacological 
preconditioning in the heart including reducing reactive oxygen species, 
improving vasorelaxation and angiogenesis, preventing inflammation and 
apoptosis, delaying atherosclerosis as well as decreasing cardiovascular 
remodelling. Interventional studies in humans need to be completed before 
resveratrol can be considered as a standard therapeutic agent. Therefore, future 
studies should focus on obtaining the level of evidence required to determine 
whether resveratrol can be added to the list of evidence-based therapies for 
cardiovascular diseases that includes renin-angiotensin system inhibitors, 
beta-adrenoceptor antagonists and calcium entry blockers.