The effects of resveratrol on endothelial progenitor cells and apoptosis biomarkers in postmenopausal women with chronic coronary heart disease: a randomized controlled trial

Background and aims Menopause is an important cardiovascular risk factor in women likely due to marked estrogen decline. Estrogens affect key processes in atherosclerosis, maintaining endothelial integrity by inhibiting endothelial apoptosis and promoting regeneration through endothelial progenitor cells (EPCs). Phytoestrogens, such as resveratrol, have therapeutic potential for women’s cardiovascular health. The present study aimed to determine whether resveratrol modulated circulating apoptosis biomarkers and EPCs in postmenopausal women with chronic coronary heart disease (CHD). Methods Twenty postmenopausal women with chronic CHD were allocated to an intervention group receiving 1,000 mg of resveratrol or placebo for 90 days. Circulating markers of apoptosis (caspases 3 and 9, survivin, cIAP2, XIAP, Bcl-2, cytochrome c, sTNFR2, and S100A12), SIRT1 and 3, cytokines and EPCs were assessed. Results At the end of the study, the resveratrol group showed an increase in serum cIAP2 ( p = 0.018) and Bcl-2 ( p = 0.043), and a decrease in caspase-9 ( B = −7.152, 95%CI = −13.554 to −0.751) and in circulating CD34+/KDR+ ( B = −0.200, 95%CI = −0.304 to −0.096). In addition, XIAP levels were lower than placebo group ( p = 0.047). No significant differences were observed for sirtuins, cytokines, lipid profile, glucose, and blood pressure. Conclusion Resveratrol increased serum Bcl-2 and cIAP2, and also reduced caspase 9 and circulating EPCs in postmenopausal women with chronic CHD, likely unrelated to circulating SIRT1 and SIRT3. The effects of resveratrol treatment in this population group should be assessed with caution, as a reduction in EPCs is associated with impaired endothelial function and an increased risk of cardiovascular disease.