The "French paradox" refers to the very low incidence and mortality rates from ischemic heart disease that exist in France despite the fact that saturated fat intake, serum cholesterol and prevalence of smoking are not lower in France than in other countries. Polyphenolic compounds from wine, have been suspected to possess activities that protect arterial wall from atherosclerosis plaque development and/or thrombotic reactivity. An European collaboration focussed on the biological effects of red wine polyphenolic extracts (RWPE) in different in vitro models of atherosclerosis-associated pathophysiological mechanisms and on in vivo modifications of parameters involved in atherosclerosis. Phytochemical fractionning of the crude RWPE will allow the identification of the most active components. Vascular tone, leukocytes thrombotic activity, adhesion of leukocytes to endothelial cells were the different topics that are developped in this program in relation to ex vivo evaluation of biological parameters after moderate red wine intake. The crude RWPE exhibited beneficial effect: it increased arterial relaxation after norepinephrine-induced contraction, it reduced the LPS-associated hyperexpression of monocyte expression of tissue factor, it interfered and reduced monocytes adhesion to endothelial cells. Moreover, an interventional study comparing red wine to spirit showed that red wine intake was able to reduce biological risk factors (lipids, fibrinogen) and leukocytes cellular components potentially involved in the pathophysiology of atherogenesis. Preliminary in vivo and in vitro results suggest that RWPE and red wine can interfere with the biological phenomenons involved in atherogenesis, explaining part of the French paradox. Identification of compound(s) of the most potent effect will allow to elucidate the role of red wine in the epidemiological observation that incidence of cardiovascular diseases is reduced in the European countries with red wine intake.