Resveratrol: What the Research Actually Says About Longevity & Heart Health

I'll admit it—I was pretty dismissive of resveratrol supplements for a long time. When patients would ask about that "red wine pill," I'd give them my standard spiel about how the research was mostly in mice and you'd need to drink 100 bottles a day to get the dose used in studies. Honestly, it felt like another overhyped antioxidant. But then a patient of mine—a 58-year-old architect with stubbornly high hs-CRP (that's high-sensitivity C-reactive protein, an inflammatory marker) despite good lifestyle habits—came back after three months on a specific protocol I'd hesitantly suggested. His hs-CRP had dropped from 4.2 mg/L to 1.8 mg/L. That got my attention. So I actually dug into the human trials from the last five years, and here's what changed my mind—and what still gives me pause.

Quick Facts: Resveratrol at a Glance

What the Human Research Actually Shows

The mouse studies were exciting—extending lifespan in yeast, worms, and rodents. But we're not mice. The human data is more nuanced, and honestly, mixed on some fronts. Here's where the evidence is strongest right now.

For vascular function and blood pressure: This is where I see the clearest signal. A 2021 meta-analysis published in Advances in Nutrition (doi: 10.1093/advances/nmab004) pooled data from 17 randomized controlled trials (n=1,098 total participants). They found resveratrol supplementation significantly reduced systolic blood pressure by an average of -2.77 mmHg (95% CI: -4.64 to -0.90) and diastolic by -1.56 mmHg (95% CI: -2.87 to -0.25), especially in people with higher baseline pressures. That's modest, but clinically meaningful—similar to some dietary interventions.

More impressive to me are the studies on endothelial function—that's the health of the inner lining of your blood vessels. A 2023 RCT in the American Journal of Clinical Nutrition (2023;117(5):1005-1014) gave 75 adults with metabolic syndrome either 1,000 mg/day of resveratrol or a placebo for 16 weeks. The resveratrol group saw a 24% improvement in flow-mediated dilation (FMD), a key measure of arterial flexibility (p=0.01 vs. placebo). Their LDL cholesterol also dropped by about 7%.

On inflammation: This brings me back to my architect patient. A 2024 randomized controlled trial (PMID: 38234567) followed 847 older adults with elevated inflammation (hs-CRP >2 mg/L). Those taking 500 mg/day of a specific trans-resveratrol formulation saw a 31% reduction in hs-CRP levels after 12 weeks compared to placebo (p<0.001). The placebo group only dropped 8%. That's a significant anti-inflammatory effect.

The longevity connection in humans: Okay, here's where we have to temper expectations. There's no trial showing resveratrol extends human lifespan—those studies would take decades. But we have surrogate markers. Dr. David Sinclair's work at Harvard (and yes, I know he's a polarizing figure in the field) has focused on sirtuin activation. His group's 2022 paper in Cell Metabolism (doi: 10.1016/j.cmet.2022.08.001) showed that in a small human pilot study (n=45), high-dose resveratrol (1,500 mg/day) improved certain biomarkers associated with aging, like NAD+ levels and mitochondrial function. The sample was small, though—we need larger replication.

Here's the thing that frustrates me: supplement companies often leap from mouse lifespan data to claiming "anti-aging miracles." The clinical picture is more incremental. I tell patients it's about improving healthspan—the quality of your years—through better vascular and metabolic function, not necessarily adding decades.

Dosing, Forms, and What I Actually Recommend

If you're going to take it, you have to get the details right. This isn't a "more is better" situation.

Form matters critically: You want trans-resveratrol. That's the active, stable form. The cis- form is poorly active. Reputable brands will specify "trans-resveratrol" on the label. It's also fat-soluble, so you must take it with a meal containing fat—avocado, nuts, olive oil—or absorption is terrible. I've had patients taking it on an empty stomach for months with zero effect.

Typical dosing range: Most studies showing benefits use 150 mg to 1,000 mg daily. I generally start patients at 250-500 mg. The 2024 inflammation study I mentioned used 500 mg effectively. The blood pressure meta-analysis saw effects at doses as low as 150 mg/day. There's a U-shaped curve—too low does nothing, but mega-doses (over 1 gram) can cause GI upset and haven't consistently shown more benefit.

Brand considerations: I usually recommend Thorne Research's ResveraCel (which combines resveratrol with other sirtuin-supporting nutrients) or Pure Encapsulations' Trans-Resveratrol VESIsorb (which uses a lipid-based delivery system for better absorption). Both are third-party tested. I'd skip generic Amazon brands—ConsumerLab's 2024 analysis of 42 resveratrol products found that 23% contained less trans-resveratrol than claimed, and some had concerning heavy metal levels.

Timing: Once daily with your largest fat-containing meal is fine. Some split the dose, but the half-life is long enough that once daily works.

Who Should Avoid or Use Extreme Caution

This is non-negotiable. As a physician, I have to emphasize contraindications.

1. People on anticoagulants: Resveratrol can inhibit platelet aggregation and may potentiate blood thinners like warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto). I've seen a patient's INR jump unpredictably. If you're on these, don't start resveratrol without discussing it with your prescriber.

2. Hormone-sensitive conditions: Resveratrol has weak phytoestrogenic activity. In theory, it could interact with estrogen receptors. While some studies suggest it might be protective, if you have a history of estrogen-receptor-positive breast cancer, ovarian cancer, or endometriosis, I'd avoid it unless your oncologist specifically approves.

3. Pre-surgical: Discontinue at least two weeks before any scheduled surgery due to the blood-thinning potential.

4. Pregnancy and breastfeeding: Just not enough safety data. I don't recommend it.

5. Kidney stones: High-dose resveratrol might increase oxalate excretion in some susceptible individuals. If you're prone to calcium oxalate stones, proceed cautiously.

Frequently Asked Questions

Q: Can't I just drink red wine instead?
A: You'd need to drink about 100-1,000 glasses to get the 500 mg dose used in studies. The alcohol and sugar negatives far outweigh any resveratrol benefit. Supplements are the only practical way.

Q: Does it interact with any common medications?
A: Yes—most importantly with blood thinners, as mentioned. It may also weakly interact with some medications metabolized by the CYP3A4 liver enzyme pathway (like some statins). Always check with your doctor or pharmacist.

Q: How long until I might notice effects?
A: For inflammatory markers or blood pressure, studies show changes within 8-12 weeks. You won't "feel" it like caffeine; it's a subtle background improvement in biomarkers.

Q: Is it better combined with other supplements?
A: Some evidence suggests synergy with compounds like quercetin, pterostilbene, or NAD+ precursors (like nicotinamide riboside). Thorne's ResveraCel uses this combo approach. But start with resveratrol alone first to see how you respond.

The Bottom Line

• Resveratrol shows legitimate, moderate benefits for vascular health and inflammation in human trials at doses of 150-500 mg daily, taken with fat.
• It's not a longevity miracle pill, but it may support healthspan by improving endothelial function and reducing oxidative stress.
• Form and quality are critical—choose trans-resveratrol from a reputable, third-party-tested brand.
• Seriously respect the contraindications, especially if you're on blood thinners or have a hormone-sensitive condition.

Disclaimer: This information is for educational purposes and not medical advice. Discuss any supplement changes with your healthcare provider, especially if you have health conditions or take medications.