Every year we lose thousands of lives to a preventable threat, cardiovascular disease.
In the US, 49.2% of the adult population, or 126.9 million people, are living with cardiovascular disease in the form of coronary artery disease, heart failure, stroke, and hypertension 1.
Cardiovascular disease is the leading cause of death around the world and is the number one reason why us and our loved ones will someday die.
This is not a consequence of aging, in most cases it’s a consequence of poor lifestyle choices.
Diet and lifestyle changes could prevent many of these cases. Diet, lifestyle, and psychosocial factors make up 90% of the risk of developing a heart attack or stroke 2 3. Here, we take a look at what cardiovascular disease is, and how a plant-based diet, along with other lifestyle factors, can delay, prevent and even reverse it.
Cardiovascular disease (CVD) is a term that describes several disorders affecting the heart and blood vessels. Coronary artery disease (CAD) is the most common type of heart disease in the US, where the coronary arteries get blocked by atherosclerotic plaques 4. This can lead to a heart attack, which is when a coronary artery gets completely blocked off by the atherosclerotic plaques.
Stroke is responsible for 1 in 6 deaths caused by cardiovascular disease. It’s caused by a blockage of the blood vessels supplying the brain 5.
Other types of cardiovascular disease include heart failure, where your heart stops pumping blood as strongly as it should, as well as cardiomyopathies, cerebrovascular disease, peripheral artery disease, and deep vein thrombosis and pulmonary embolism.
This information page will largely focus on coronary heart disease and stroke.
Symptoms can vary greatly between individuals and different conditions.
Some people experience chest pain (angina) and shortness of breath when living with heart disease 6.
Others may have no symptoms at all until they suffer a heart attack or heart failure.
Symptoms of a heart attack include chest pain, shortness of breath, light-headedness, and pain in the arms, jaw, neck, and back.
Various tests can be done by your doctor depending on what condition they think you may have.
Some common tests to assess cardiovascular disease include:
The treatment options will depend on the specific type of cardiovascular disease a person is dealing with, treatments include
Treatments usually aim to manage the symptoms, prevent the condition progressing any further, and prevent further complications such as a heart attack or stroke
In order to develop coronary artery disease, fatty, cholesterol-rich deposits accumulate in the walls of your coronary arteries, creating an atherosclerotic plaque. This cholesterol-rich gunk hardens the arteries. The process happens over many years, and as the plaque slowly builds up, it narrows the arteries more over time, until one day it may rupture, causing a blood clot in the artery and a subsequent heart attack.
Various factors increase the risk of this happening.
The risk factors for heart disease and stroke are those largely within our control: an unhealthy diet that is high in animal-derived and processed foods, physical inactivity, smoking, and excess alcohol consumption 1.
High blood pressure (hypertension), high blood glucose, and blood lipid abnormalities are also major risk factors for cardiovascular disease. These are also heavily influenced by the diet and lifestyle factors described above.
Age, gender, ethnicity, and genetics also impact the risk of developing cardiovascular disease, but these cannot be modified 6.
The life-saving impacts of a plant-based diet are most pronounced for cardiovascular disease. There is a huge body of evidence that demonstrates how switching to a plant-based diet prevents cardiovascular disease.
The first bit of evidence comes from rural China and Africa. Doctors and scientists discovered coronary heart disease was almost non-existent in these regions, which they attributed to people’s very low cholesterol levels. These regions shared commonalities in their diets: mostly plant-based, lots of fiber, and minimal animal products and fat. Scientists believed this to be the reason behind low levels of cholesterol and heart disease 7 8. When populations move from low-risk areas to high-risk areas like western countries, cardiovascular disease risk increases, suggesting the results are due to environmental factors like diet and lifestyle, not genetics 9 10.
Western populations following modernized plant-based diets also have a reduced risk of heart disease. A study looking at Seventh-day Adventists from the US found a 40% reduced risk of coronary heart disease in vegetarians compared to non-vegetarians and a 29% reduction in cerebral vascular disease events (affecting the blood supply to the brain, including strokes) 11.
Another study found those consuming plant-based diets had a 31% reduction in cardiovascular disease mortality compared to those eating a more omnivorous diet 12.
So what contributes to the increased disease risk in omnivores? One major factor is red meat; a higher intake significantly increases the risk of heart disease 13. Red meat is high in saturated fat, and other harmful components which we discuss below.
Here are the ways a plant-based diet can prevent cardiovascular disease, and maintain good cardiovascular health:
Other benefits of plant foods for cardiovascular health include:
It’s never too late to switch to a plant-based diet. On a whole-food plant-based diet, not only can you stop heart disease in its tracks, you may be able to reverse it.
A low-fat plant-based diet is the only diet shown to actually reverse heart disease in some patients 26 27 28 (Ornish et al.1990). Some studies combined a plant-based diet with exercise and stress management to reverse heart disease 28.
When participants were switched to a whole-food plant-based diet, the foods causing harm to the cardiovascular system were cut out of their diet. This included saturated fat and cholesterol, food that damages endothelial cells, and TMAO. The participants' bodies were given a chance to heal; to improve endothelial function, and restore blood flow. And what did the researchers see? Those people started to get better 26.
So, when the artery-clogging diet stops, so does the artery-clogging itself, and some of the plaque actually begins to dissolve away.
The participants of the study were also provided with nutrition counseling, recipes and strategies for going plant-based, helping them to make and maintain the transition.
This is different to any medication your doctor can offer - it doesn’t just mask the disease, it treats the root cause and allows you to actually heal.
3. O’Donnell, M. J. et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. The Lancet 388, 761–775 (2016).
6. Gaziano, T., Reddy, K. S., Paccaud, F., Horton, S. & Chaturvedi, V. Cardiovascular Disease. Disease Control Priorities in Developing Countries. 2nd edition (The International Bank for Reconstruction and Development / The World Bank, 2006).
9. Benfante, R. Studies of cardiovascular disease and cause-specific mortality trends in Japanese-American men living in Hawaii and risk factor comparisons with other Japanese populations in the Pacific region: a review. Hum. Biol. 64, 791–805 (1992).
11. Kwok, C. S., Umar, S., Myint, P. K., Mamas, M. A. & Loke, Y. K. Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: A systematic review and meta-analysis. Int. J. Cardiol. 176, 680–686 (2014).
12. Kim, H. et al. Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults. J. Am. Heart Assoc. 8, e012865 (2019).
14. Pettersen, B. J., Anousheh, R., Fan, J., Jaceldo-Siegl, K. & Fraser, G. E. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr. 15, 1909–1916 (2012).