Heart disease, a type of cardiovascular disease, remains the leading cause of death for both men and women, accounting for 17.4% of all U.S. deaths in 2021. An unhealthy diet is conservatively estimated to contribute to 49.2% of all cardiovascular disease deaths.

The term “cardiovascular disease” (CVD) is often used in the singular, but this can be misleading. Cardiovascular diseases (CVDs) actually encompass a range of disorders affecting the heart and blood vessels.

Coronary artery disease (CAD) is one example. In CAD, the arteries that supply blood to the heart become narrowed or blocked with plaque, composed mainly of cholesterol. This build up is called atherosclerosis and is the most common cause of heart attacks. Peripheral artery disease (PAD) results from similar blockages in arteries, especially those leading to the legs and feet. When vessels to the brain are blocked, it can cause a stroke. Heart failure occurs when the heart cannot pump blood effectively to meet the body’s needs. Hypertension, another CVD, alters the structure and function of blood vessels and can lead to fibrosis (scarring), plaque buildup, and subsequent conditions such as CAD, PAD, heart failure, arrhythmias, and stroke.

Diagnosis

A medical provider can diagnose CVDs using a variety of measures including results from blood labs, blood pressure, echocardiogram, stress test, magnetic resonance imaging (MRI), and others.

A blood lipid panel is a readily available and relatively non-invasive measure that includes total cholesterol (desirable below 200 mg/dL), low-density lipoprotein (LDL) cholesterol (preferably below 100 mg/dL), high-density lipoprotein (HDL) cholesterol (target above 60 mg/dL), and triglycerides (healthy below 150 mg/dL). Blood pressure under 120/80 mm Hg and fasting glucose below 100 mg/dL are also considered healthy.

Dietary Interventions

While many other modifiable risk factors contribute to CVDs, such as smoking and inactivity, an unhealthy diet high in saturated fats, trans fats, cholesterol, sodium, and refined carbohydrates (including added sugars) significantly increases risk. Such diets can cause hypertension, hyperlipidemia, obesity, and diabetes, all of which raise CVD risk or worsen existing CVDs.

A plant-centric diet, rich in fiber and unsaturated fats, helps lower cholesterol. The soluble fiber from ingested plant foods binds to cholesterol in the intestines, ultimately removing it. Unsaturated fats raise HDL, which helps clear LDL from arteries. Reducing sodium can lower blood pressure, and cutting saturated fats and refined carbs reduces blood cholesterol and provides additional benefits.

Heart-healthy diets like Dietary Approaches to Stop Hypertension (DASH), the Mediterranean diet, and plant-based diets share these features.

Foods high in natural nitrates, like spinach, kale, beets, celery, and radishes, can help relax blood vessels, improve oxygen delivery, lower blood pressure, and enhance circulation, further reducing CVD risk.

Ultra-processed foods, in contrast, may increase oxidative stress and inflammation, counteracting the antioxidant properties and other benefits of a whole-foods, plant-centric approach.

Medical Intervention

Although attention to diet should be the first intervention and should remain throughout treatment, a medical doctor or other authorized provider may need to prescribe medications to further lower blood pressure (antihypertensives), lower LDL cholesterol (statins), prevent blood clots (antiplatelets and anticoagulants), increase blood flow (nitrates), and reduce blood sugar (SGLT2 inhibitors and GLP-1 agonists).

Summary and Conclusion

Cardiovascular diseases are complex, multifactorial disorders with diet playing a central role in both their development, prevention, and reversal. While medical interventions may be necessary, dietary changes, especially plant-centric, low-sodium, and low-refined carbohydrate approaches, offer powerful, evidence-based strategies to reduce risk, manage disease progression, and improve long-term cardiovascular outcomes.

 About the Author

Patrick Traynor, PHD, MPH, RD, CPT is a registered dietitian with an insurance-based practice, MNT Scientific, LLC in South Lake Tahoe, CA, Minden, NV, & Ashland, OR. In-office or video appointments can be requested online at MNTScientific.com or by calling (530)429-7363. Inquiries can be directed to info@mntscientific.com.