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Background <p>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.</p> Methods <p>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.</p> Results <p>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], <i>P</i> = 0.030)] and LDL-C [MD = -0.56 mmol/L (95%CI [-1.09, -0.02], <i>P</i> = 0.041)], but also with a modest reduction in HDL-C [MD = -0.05 mmol/L (95%CI [-0.10, -0.01], <i>P</i> = 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 &lt; 30, whereas LDL-C reductions were more pronounced in patients aged ≤ 60 years and those with BMI ≥ 30.</p> Conclusions <p>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.</p> Trial registration <p>The study protocol has been registered with PROSPERO under the registration number: CRD420261283606.</p>

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Effects of vegetarian or vegan diets on cardiovascular metabolic health in patients with cardiovascular disease: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Saikun Wang,
  • Liu Hao,
  • Kun Liu,
  • Chao Sun,
  • Chunhua He,
  • Wenyu Cai,
  • Yihao Zhang,
  • Zhenhua Wang,
  • Yanbin Liu,
  • Yang Zhang

摘要

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.