The French paradox three decades later: Role of inflammation and thrombosis

•French paradox is still an issue for debate although three decades have pasted.•Wine contains a mixture of micro-constituents in proper quality and quantity.•Wine micro-constituents exert potent anti-inflammatory and anti-platelet actions.•Controlled clinical studies are still needed to draw safe conclusions. Although, three decades have pasted from the introduction of “French Paradox”, is still an issue for debate. Epidemiology supports the J-shaped relationship between wine consumption and vascular events as well as cardiovascular mortality with a maximum protection at 21 g of alcohol consumption in the form of wine per day. Nevertheless, the aforementioned studies have used an observational design that raises concerns about potential confounding. Randomized clinical studies may provide data to end the controversy and in parallel with in vitro experiments to elucidate the mechanisms by which wine affects cardiovascular disease. In this concept, this review aims to address the presence of bioactive wine micro constituents, their potential mechanisms of action and also to summarize the cardio-protective effects of wine intake based on clinical trials. The role of wine micro-constituents in inflammation and haemostasis is discussed in detail.