Effects of vegetarian or vegan diets on cardiovascular metabolic health in patients with cardiovascular disease: a systematic review and meta-analysis
- 1Department of Rehabilitation, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong 250011 China
- 2Department of Rehabilitation, Jinan Hospital, Jinan, Shandong 250013 China
Abstract
Background: Vegetarian or vegan diets have been associated with favorable cardiovascular outcomes in the general population; however, their effects on cardiometabolic risk factors in patients with established cardiovascular disease (CVD) remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of vegetarian or vegan dietary interventions on cardiometabolic risk factors in patients with CVD.
Methods: A systematic search of five electronic databases was conducted from inception to January 1, 2026. Randomized controlled trials (RCTs) comparing vegetarian or vegan diets with omnivorous diets in adult patients with CVD were included. Outcomes of interest included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models according to heterogeneity. Subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity.
Results: Six RCTs involving 325 patients with CVD were included. Compared with omnivorous diets, vegetarian or vegan diets were associated with significant reductions in TC [MD = -0.63 mmol/L (95%CI [-1.20, -0.05], P = 0.030)] and LDL-C [MD = -0.56 mmol/L (95%CI [-1.09, -0.02], P = 0.041)], but also with a modest reduction in HDL-C [MD = -0.05 mmol/L (95%CI [-0.10, -0.01], P = 0.023)]. No significant effects were observed on SBP, DBP, or TG levels. Subgroup analyses indicated that low-fat vegan diets, intervention duration, age, and BMI influenced lipid outcomes. Greater reductions in TC were observed in patients aged ≤ 60 years and those with BMI < 30, whereas LDL-C reductions were more pronounced in patients aged ≤ 60 years and those with BMI ≥ 30.
Conclusions: Vegetarian or vegan diets, particularly low-fat vegan diets, may improve lipid profiles by reducing TC and LDL-C in patients with established CVD. No significant benefits were observed for blood pressure or triglycerides. These findings suggest that plant-based dietary interventions may serve as a complementary strategy for the management of cardiometabolic risk factors in CVD patients.
Trial registration: The study protocol has been registered with PROSPERO under the registration number: CRD420261283606.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12937-026-01373-z.
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BibTeX
@article{wang2026effects,
title = {{Effects of vegetarian or vegan diets on cardiovascular metabolic health in patients with cardiovascular disease: a systematic review and meta-analysis}},
author = {Saikun Wang and Hao Liu and Kun Liu and Chao Sun and Chunhua He and Wenyu Cai and Yihao Zhang and Zhenhua Wang and Yanbin Liu and Yang Zhang},
journal = {Nutrition Journal},
year = {2026},
month = aug,
doi = {10.1186/s12937-026-01373-z},
url = {https://doi.org/10.1186/s12937-026-01373-z},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Effects of vegetarian or vegan diets on cardiovascular metabolic health in patients with cardiovascular disease: a systematic review and meta-analysis
AU - Saikun Wang
AU - Hao Liu
AU - Kun Liu
AU - Chao Sun
AU - Chunhua He
AU - Wenyu Cai
AU - Yihao Zhang
AU - Zhenhua Wang
AU - Yanbin Liu
AU - Yang Zhang
PY - 2026
DA - 2026/08/05
JO - Nutrition Journal
DO - 10.1186/s12937-026-01373-z
UR - https://doi.org/10.1186/s12937-026-01373-z
AB - Background: Vegetarian or vegan diets have been associated with favorable cardiovascular outcomes in the general population; however, their effects on cardiometabolic risk factors in patients with established cardiovascular disease (CVD) remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of vegetarian or vegan dietary interventions on cardiometabolic risk factors in patients with CVD. Methods: A systematic search of five electronic databases was conducted from inception to January 1, 2026. Randomized controlled trials (RCTs) comparing vegetarian or vegan diets with omnivorous diets in adult patients with CVD were included. Outcomes of interest included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models according to heterogeneity. Subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity. Results: Six RCTs involving 325 patients with CVD were included. Compared with omnivorous diets, vegetarian or vegan diets were associated with significant reductions in TC [MD = -0.63 mmol/L (95%CI [-1.20, -0.05], P = 0.030)] and LDL-C [MD = -0.56 mmol/L (95%CI [-1.09, -0.02], P = 0.041)], but also with a modest reduction in HDL-C [MD = -0.05 mmol/L (95%CI [-0.10, -0.01], P = 0.023)]. No significant effects were observed on SBP, DBP, or TG levels. Subgroup analyses indicated that low-fat vegan diets, intervention duration, age, and BMI influenced lipid outcomes. Greater reductions in TC were observed in patients aged ≤ 60 years and those with BMI < 30, whereas LDL-C reductions were more pronounced in patients aged ≤ 60 years and those with BMI ≥ 30. Conclusions: Vegetarian or vegan diets, particularly low-fat vegan diets, may improve lipid profiles by reducing TC and LDL-C in patients with established CVD. No significant benefits were observed for blood pressure or triglycerides. These findings suggest that plant-based dietary interventions may serve as a complementary strategy for the management of cardiometabolic risk factors in CVD patients. Trial registration: The study protocol has been registered with PROSPERO under the registration number: CRD420261283606. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12937-026-01373-z.
SN - 1475-2891
ER -