Heart disease, also known as cardiovascular disease (CVD), is a general term used to describe medical issues with either the heart (cardio), the blood vessels (vascular) and blood circulation, or both. The term covers conditions, including heart attacks, strokes and abnormal heart rhythms, among others. In this article, we’ll outline the various types of cardiovascular disease, including the symptoms to watch out for. We will also present some of the advice from the British Heart Foundation and the NHS about how to reduce your risks of developing cardiovascular disease.
Mainly though, the article will be attempting to assess whether a vegan diet can reverse heart disease and indeed whether CVD is indeed reversible at all. And, if a vegan diet can’t actually reverse all or some of the conditions that fall under the CVD umbrella, could it perhaps reduce the risk of developing such conditions in the first place? There will no doubt be many people out there, especially those who were attracted by the many health reasons to be vegan, who are familiar with the idea that veganism brings a range of health benefits. But here we will focus specifically on cardiovascular health. So, let us begin with a little more detail about heart disease.
What Is Heart Disease?
Recent figures from a British Heart Foundation factsheet suggest there are 7.6 million people with heart and circulatory diseases in the UK, so this is clearly a very serious and widespread issue. The heart is not only essential to humans (and most animals), it is also fascinating. It is a feat of engineering that is essentially two pumps that work in unison to ensure blood (and with it, oxygen and nutrients) can travel around the whole body.
In an average lifetime, a human heart beats somewhere in the region of 2.5 billion times. It’s no wonder such a hardworking organ could suffer a little wear and tear. And although there are some genetic heart conditions that can cause problems for people, there are plenty of lifestyle “risk factors” that make you more like to develop CVD. But what conditions are covered by the term?
There are a lot of different types of cardiovascular disease, often with overlapping symptoms, but according to the NHS, there are the four main types, which we’ll describe here.
Coronary Heart Disease
Coronary heart disease (CHD) happens when oxygenated blood is prevented from flowing readily to the heart or if it is blocked completely. Clearly, this is extremely serious and can result in one of the following:
- Heart Failure – The heart is no longer able to pump enough blood around the body.
- Heart Attack – The flow of blood to the heart is blocked so the heart cannot function properly.
- Angina – The flow of blood to the heart is restricted (usually resulting in acute chest pain).
Figures from the British Heart Foundation suggest that CHD is the leading cause of death in the world and that 1 in 8 men and 1 in 13 women die from coronary heart disease in the UK (these stats were based on 2019 figures, i.e. before COVID-19).
Strokes & TIAs
Stroke or transient ischaemic attacks (TIAs, also known as “mini-strokes”) can occur when the flow of blood to the brain is blocked or significantly reduced. Strokes can cause permanent brain damage or even death. Generally with TIAs, the reduced blood flow to the brain is only temporary.
Symptoms of a stroke or TIA can include someone’s face drooping on one side, being unable to lift their arms due to numbness, slurred speech or loss of the ability to speak at all. If such symptoms occur, emergency medical help should be sought immediately.
Peripheral Arterial Disease
As the name suggests, this occurs when there is a reduced flow of blood to the peripheries, i.e. the limbs. It is usually the legs that are affected and it can cause pain in the legs that is worse when walking, sensations of numbness in the legs, open sores or even hair loss on the legs and feet.
The aorta is the largest blood vessel in the human body and is the artery that carries oxygenated blood from the heart to various parts of the body. The aorta extends from the heart to the abdomen and has many arteries that branch off it to transport blood elsewhere.
Aortic disease refers to conditions that specifically affect this crucial vessel. One of the more common aortic disease conditions is an aortic aneurysm. This is when the aorta becomes weakened and it begins to bulge. If left untreated it could rupture and cause internal bleeding.
Other Types of Heart Disease
As mentioned, there are various other conditions that fall under the heart disease umbrella. These could include congenital heart defects (i.e. those someone is born with), heart valve disease, an infection of the heart, and problems with the heart’s rhythm (arrhythmias), among others. If you are concerned you might have any heart problems, consult your doctor.
What Causes Heart Disease?
To understand whether a vegan diet can reverse heart disease, lessen the effects of such issues or reduce the chances of getting it in the first place, it’s important to look briefly at what causes it. Leaving aside congenital and genetic conditions, and things like infections, it is not fully understood what specifically causes cardiovascular disease conditions. But, as the NHS website states, “there are lots of things that can increase your risk of getting it”. These are known as “risk factors”.
Cardiovascular Disease Risk Factors
These are the main risk factors of developing cardiovascular disease as outlined by the British Heart Foundation. We’ve split them into those you can’t do anything about, those you might be able to affect, and those factors over which you can exert at least some control.
Risk Factors Over Which You Have No Control
- Family History of Heart Disease – If your family developed CVD, unfortunately, you will have a higher chance of also developing it.
- Ethnic Background – People of South Asian origin are more likely to develop CHD than those of a white European origin, while those of African or Afro-Caribbean origins are more likely to have strokes.
- Sex – Men are more likely to get CVD earlier than women.
- Age – The older you are, the more likely you are to get CVD.
Clearly, one cannot change their family history, how old they are or their ethnic background. Whilst it is possible to alter one’s sex, it is not clear whether this would have a discernible effect on the chances of developing CVD.
Risk Factors Over Which You Might Have Some Control
- Having Diabetes – Diabetes can cause damage to blood vessels that can increase the risk of developing CVD.
As we discuss in detail in our Vegan Diet and Diabetes article, there is nothing you can do about type 1 diabetes. But, it might be possible – according to research carried out by the Diabetic Association – to put type 2 diabetes into remission by undertaking a “low-calorie, diet-based, weight management programme”.
Risk Factors Over Which You Have at Least Some Control
- Smoking – The single biggest risk factor for CVD.
- Stress – Linked to less healthy lifestyle choices rather than being a “cause” in itself.
- Alcohol – Drinking more than the recommended amount.
- High Blood Pressure – Increases chances of having a heart attack or stroke.
- High Cholesterol Levels – Increases risk of heart attack and stokes.
- Being Physically Inactive – Inactivity it likely to lead to other risk factors.
- Being Overweight or Obese – Another big risk factor that can increase the chances of CVD including heart attacks and strokes.
Some of these risk factors could be categorised as “lifestyle choices”. Though one can’t control what they were fed as children or whether their life circumstances put them at particular risk of stress, adults certainly have the capacity to choose whether or not they take regular exercise.
People who are addicted to smoking or alcohol might conceivably be seen to have less control over these particular factors. Some of these factors overlap; for instance, if you drink excessive amounts of alcohol, you might be less likely to exercise regularly or eat a healthy diet (in general).
A Word About Atheroma
Medical professionals seem reluctant to name specific “causes” of heart disease, even though the presence of “risk factors” would imply that they are often causes by another name. The issue is that the exact mechanism of how these risk factors go on to cause heart disease is not fully understood. Nor do we know why some overweight, heavy-drinking, smokers will develop such issues but equally others will not.
That said, when it comes to atherosclerosis – the build-up of fatty and other materials in the arteries – there is little doubt this can cause various conditions that fall within the cardiovascular disease grouping. Various studies have shown this and there is a clear causal link.
Indeed, Australia’s internationally renowned Heart Research Institute (HRI) claims that “atherosclerosis is the main underlying cause of cardiovascular disease (CVD)”. It cannot be put any clearer than that. The problem is, as the HRI go on to say, the exact causes of atherosclerosis are not known… and they then give many of the same things mentioned above as risk factors for atherosclerosis, namely high blood pressure, inactivity, obesity, diabetes, high cholesterol and, perhaps tellingly, “poor nutrition”.
Ultimately, aside from smoking, drinking alcohol and stress, a person’s diet is connected to all the other controllable risk factors. Poor nutrition would often suggest a diet that is high in cholesterol and saturated fats, along with plenty of simple carbohydrates, refined sugar and processed food. This kind of diet can lead to obesity, high blood pressure, high cholesterol and (type 2) diabetes, all of which are risk factors for CVD. A poor diet could make it harder to maintain high physical activity levels too (either because someone is obese or because they don’t have the energy to exercise effectively).
Could a Vegan Diet Reverse Heart Disease?
There have been various claims, articles and books over the years, often by experienced and well-qualified cardiologists, about how to reverse heart disease. From a research perspective, the jury is out over whether or not it is something that can be reversed at all, but this would most likely depend on the severity and precise nature of the condition(s) involved.
Some of the possible hype about a plant-based diet being able to actually reverse CVD comes from a 2014 study carried out by scientists with affiliations to the Wellness Institute of the Cleveland Clinic in Ohio, a respected US academic medical institution.
A 2014 Study
The study followed 198 patients with “established cardiovascular disease (CVD)” who were interested in trying to follow a plant-based diet in addition to their usual medical treatments. Of the 198 patients, 177 stuck to the plant-based diet (that also excluded added oil). Of those who adhered to a plant-based diet, only one suffered what the researchers described as a “major cardiac event judged to be recurrent disease” (a stroke in this case), giving a recurrent event rate of 0.6%. Of those who did not adhere to a plant-based diet, 62% experienced adverse events. In conclusion, the study said, “those who sustained plant-based nutrition for a mean of 3.7 years experienced a low rate of subsequent cardiac events”.
The problem is, to suggest that plant-based diets can definitely “reverse” CVD on the basis of a study containing just 198 participants is not overly convincing. The evidence is promising, but it is far from conclusive and much larger studies would be required to provide robust enough evidence to commit to the notion that heart disease can be reversed by being a vegan. It is also perhaps inaccurate to say that the disease was “reversed”, as studies over a longer period would be needed to be able to definitely state that this was the case.
Given the lack of other concrete evidence available, we are not willing to say that a vegan diet can reverse heart disease. But that doesn’t mean it can’t reduce or even remove the dangers from the various risk factors in relation to a wide range of CVD conditions.
How a Vegan Diet Could Reduce the Risk of Developing Heart Disease
There has been plenty of research carried out that gives fairly solid evidence that following a plant-based diet can bring all kinds of health benefits. Of course, simply being vegan does not guarantee good health, especially since the emergence of so much vegan fast food, processed food and snacks in recent years. They may not contain animal products, but that doesn’t stop something like vegan ice cream, or vegan chocolate, for instance, containing plenty of sugar and fat.
But if you follow a plant-based diet that contains mostly fresh vegetables and fruit, pulses, nuts and seeds and includes little in the way of processed, high-fat or high-sugar foods, there are plenty of health gains to be had. On the flip side, meat and dairy naturally contain more saturated fat and cholesterol than vegetables and other vegan-friendly foods.
For instance, research carried out by medical testing company, Medichecks analysed the data of 10,000 of their customers to assess the possible health benefits of a vegan diet. They found that:
- The blood sugar of vegans was around 5% lower than that of non-vegans
- Non-vegans had higher levels of non-HDL cholesterol (12.2% higher) than vegans (non-HDL is “bad” cholesterol).
A lower blood sugar level (assuming not too low) would tend to reduce the risk of developing type 2 diabetes (a CVD risk factor) and as high cholesterol is also a risk factor for CVD, having lower levels in the body is going to reduce your overall risk of developing cardiovascular problems.
A well-regarded study published in the Journal of the American Heart Association in 2018 also suggests a vegan diet can help maintain good cardiovascular health. It suggested a plant-based diet was better able to reduce “high‐sensitivity C‐reactive protein as a risk marker of major adverse cardiovascular outcomes in coronary artery disease” than the American Heart Association (AHA)-recommended diet. The diet the AHA recommended entailed eating low-fat dairy, skinless poultry and fish (alongside various vegetables, whole grains, nuts and legumes) and only limited amounts of saturated fat, trans fat, red meat, sweets and sugar-sweetened beverages.
In relation to obesity, following a diet that is high in fibre has been shown by research published in the Lancet to lead to a reduction of cardiovascular-related mortality and incidence of coronary heart disease by as much as 30%. And given that a vegan diet tends to be much higher in fibre than a non-vegan diet (a claim that is also backed up by robust research), those who avoid meat and dairy could be doing their cardiovascular health plenty of favours.
Links Between Meat/Dairy & Heart Disease
Following a well-balanced vegan diet with lots of fresh fruit and veg, pulses and wholegrains can clearly have health benefits. But does it follow that eating a non-vegan diet is necessarily bad for someone’s health? Well, it depends on how much meat and dairy someone consumes. There is plenty of evidence out there, however, that consumption of meat – and processed meat in particular – has a range of negative health implications, including an increased risk of developing cardiovascular disease.
Some research has suggested that consuming red meat, whether processed or not, has serious implications for heart health. In relation to dairy, whilst some studies have found no increased risk of CVD by consuming dairy per se, some of the most robust studies have discovered that if dairy fat is swapped for vegetable fat, the risk of cardiovascular disease dropped by between 10% and 24%.
Veganism & Heart Disease: Conclusions
There is no doubting that a vegan diet can confer many health benefits. But that assumes the vegan diet is a healthy and well-planned one that includes plenty of fresh fruit and veg, whole grains, nuts, seeds and fibre and not a lot of sugar, saturated fat or processed food. There appears insufficient evidence to suggest with any degree of confidence that a balanced vegan diet can reverse heart disease. But there seems to be enough robust research out there that a person consuming a plant-based diet will have a decreased risk of developing cardiovascular disease compared to someone consuming a diet containing meat and dairy (especially red and processed meat).
Given that vegetarians and vegans have a lower prevalence of obesity, which is another CVD risk factor, the argument that veganism leads to a lower chance of heart disease gets even stronger. In summary, being vegan doesn’t guarantee you won’t develop cardiovascular disease. But if you follow a well-balanced, fibre-rich vegan diet, your chances of developing CVD in the future will be lower than if you ate an omnivorous diet (especially one that included lots of red and processed meat).