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Cardiovascular disease: impacts and risks

Cardiovascular disease (CVD) refers to all the diseases of the heart and circulation, including coronary heart disease, atrial fibrillation, heart attack, congenital heart disease and stroke.

Cardiovascular disease definition

Cardiovascular disease (CVD) refers to all the diseases of the heart and circulation, including coronary heart disease , atrial fibrillation , heart attack , congenital heart disease , heart failure and stroke .

The cardiovascular system is also known as the circulatory system. It consists of the heart and all the blood vessels in the body (arteries, veins and capillaries), and it supplies the body with oxygen- and nutrient-rich blood.

CVD can affect any part of the cardiovascular system, and symptoms may not always be visible. Different CVDs may develop at the same time or lead to other CVDs. For example, people with atrial fibrillation are at greater risk of suffering a stroke .

CVD is the lead­ing cause of death world­wide, tak­ing an esti­mat­ed 17 . 9 mil­lion lives every year – rep­re­sent­ing 32 per cent of all glob­al deaths.

What causes cardiovascular disease?

There is no singular cause of CVD. However, the primary cause of CVD is atherosclerosis – the build-up of fatty plaques on the walls of the arteries. These plaques are made up of fat, cholesterol, calcium and other substances. Over time, the plaques harden, narrowing the opening of the arteries and restricting blood flow. These atherosclerotic plaques can break, forming a thrombus ( blood clot ) that can further limit, or even block the flow of blood throughout the body.

Atherosclerotic plaque

There are two types of atherosclerotic plaque : stable and unstable.

Stable plaques can lead to a narrowing of the arteries over time, eventually so much so that they restrict blood flow. This type of plaque can be detected and treated.

Unstable plaques have a tendency to rupture even before they are large enough to obstruct blood flow, and this can lead to a blood clot. These plaques can be dangerous because they can cause a sudden blockage to blood flow in the body with no warning. There are currently no simple, non-invasive tests available to specifically detect unstable plaque.

The primary cause of CVD is atherosclerosis - the build-up of fatty plaques on the walls of the arteries that over time hardens, narrowing the opening of the arteries and restricting blood flow.

Cardiovascular diseases

Some of the most common cardiovascular diseases include the following.

  • Abnormal heart rhythms: Atrial fibrillation , where the heart beats irregularly or rapidly, is one example.
  • Acute coronary syndrome : This covers all situations where blood supply to the heart is blocked.
  • Congenital heart disease : The most common type of birth defect, congenital heart disease is a general term for problems with the heart’s structure that are present from birth, such as single-ventricle congenital heart disease (Fontan-CHD).
  • Heart attack : Also known as myocardial infarction, heart attack occurs when the heart is deprived of oxygen due to a blocked artery. A heart attack can lead to death.
  • Heart failure : This is when the heart does not work as well as it should in pumping blood and oxygen around the body. A “stiff” type of heart failure called heart failure preserved ejection fraction (HFpEF), where the heart cannot relax properly, is the most common type.
  • Peripheral artery disease : Also known as peripheral vascular disease, this is when the narrowing of arteries results in reduced blood flow to parts of the body outside of the heart or brain, such as the legs and feet.
  • Preeclampsia : Preeclampsia is high blood pressure that occurs during pregnancy and the postpartum period. It affects both the mother and unborn baby, and can lead to maternal and infant death.
  • Stroke : Stroke occurs when the blood supply to the brain is suddenly cut off, such as by a blood clot blocking an artery to the brain. Stroke is a leading cause of disability globally.

Cardiovascular disease symptoms

CVD can cause symptoms anywhere in the body. However, some symptoms and risk factors can be “silent”, and people may be unaware they have CVD. For example, high blood pressure may initially cause no symptoms.

Symptoms of CVD depend on the specific condition, but the most common symptoms of an underlying problem with the heart or cardiovascular system include:

  • pain or pressure in the chest
  • pain or discomfort in the arms, jaw or back
  • shortness of breath
  • dizziness or light-headedness
  • cold sweats.

Symptoms of CVD can also differ between men and women. For example, men are more likely to have chest pain, while women are more likely to show other symptoms, such as shortness of breath and nausea.

Speak to your doctor if you are concerned about any of these symptoms.

What is the impact of cardiovascular disease?

CVD is Australia’s – and the world’s – number 1 killer. Every 18 minutes, one Australian dies from CVD. That’s 79 deaths every day. 1, 2

Over 6 per cent of Australian adults have one or more cardiovascular conditions, which equates to 1.2 million people. With one in every 20 Australians being affected by CVD, someone you know – or maybe even you yourself – has been touched by CVD. 3, 4

The number of people dying or suffering disability from CVD has been increasing in recent years. This is in part due to the increasing prevalence of ‘lifestyle diseases’ such as obesity and diabetes – major risk factors for CVD.

The financial cost of cardiovascular disease

As a major cause of death and disability in Australia, CVD places a huge burden on the economy as well as the healthcare system, costing $12.7 billion a year and being responsible for 11 per cent of all hospitalisations. 2, 4

Risk factors for cardiovascular disease

The risk factors that can be changed or managed include the following.

  • High blood pressure : High blood pressure can overload the heart and arteries and speed up atherosclerosis. High blood pressure can be managed through dietary changes such as lowering salt intake. Medications are also available.
  • High cholesterol : High levels of the “bad” cholesterol (LDL cholesterol) can add to the build-up of plaque in the arteries. High cholesterol can be managed through medication and dietary changes .
  • Inactivity : Being inactive can contribute to being an unhealthy weight and increase the risk of other risk factors like high blood pressure and cholesterol levels. It’s also important to stay active after a CVD diagnosis .
  • Obesity : Being overweight or obese can increase the risk of a number of health problems, including other CVD factors like high blood pressure and high cholesterol. Eating a healthy diet and getting regular exercise can help you get to and maintain a healthy weight.
  • Diabetes : People living with diabetes are over twice as likely to develop CVD. In some cases, diabetes can be managed through diet and a healthy lifestyle.
  • Poor nutrition : A diet high in saturated fat, trans fat, LDL cholesterol, salt and sugar can contribute to being an unhealthy weight. Try to eat a balanced, nutritious diet .
  • Smoking : Smoking can increase the risk of CVD by damaging the arteries. It also affects blood flow through the arteries and can make blockages more common. Smokers are twice as likely to have a heart attack.
  • Stress : Ongoing stress can damage the arteries and worsen other CVD risk factors.

Making lifestyle changes such as these can prevent up to 80 per cent of premature CVD, stroke and diabetes. 6

Cardiovascular disease risk factors you cannot change

There are some risk factors for CVD that cannot be changed, so it’s important to keep an eye on your heart health if any of these factors are present.

  • Increasing age: The risk of CVD increases with age. More than one in four people over the age of 75 have CVD. 4
  • Gender: Men are slightly more at risk of CVD than women, but CVD is still a leading cause of death and disability in women. CVD risk in women can also be under-recognised and under-treated, and there are several heart health mistakes women can avoid . The CVD risk for women also increases after menopause.
  • Family history of CVD: If a close family member, such as a grandparent, parent or sibling, has CVD, there may be an additional risk. This is especially true if a parent developed CVD at an early age.
  • Ethnicity: Aboriginal and Torres Strait Islander people are at increased risk of CVD.

Cardiovascular disease prevention

To help prevent CVD and the risk of heart attack and stroke, it’s important to have regular heart health checks with your doctor. The earlier that CVD is detected, the earlier that it can be treated and managed, perhaps preventing a more severe health issue.

In Australia, heart health checks are covered by Medicare. They usually take around 20 minutes.

During a heart health check, your doctor can determine your overall risk of CVD by considering a number of factors, including whether you have any of the lifestyle risk factors, such as high cholesterol levels and whether you smoke. They will also consider your family history of CVD, ethnicity, age and gender, as well as any other health conditions that you may have.

Your doctor will then use treatment guidelines to advise interventions you can take to reduce your risk, which may include medication.

Simple steps to prevent cardiovascular disease

Regardless of the outcome of a heart health check, there are simple steps everyone can take to improve heart health and decrease the risk of CVD.

  • Eat a heart-healthy diet that includes a variety of fruit, vegetables , wholegrains and healthy protein sources .
  • Limit the amount of processed foods eaten, and check their nutrition labels . These foods can contain high amounts of saturated fat, trans fat, LDL cholesterol, salt and sugar that can be detrimental to health.
  • Avoid sugary drinks and stay well-hydrated with water instead.
  • Choose healthier sources of fat , such as nuts, seeds and avocados.
  • Make exercise or physical activity a regular part of your day. Aim for at least 30 minutes of moderate-intensity physical activity on most days, but being active for any amount of time is better than none.
  • Maintain a healthy weight through regular exercise and a balanced diet .
  • Limit alcohol intake . Drinking too much alcohol can raise the levels of some fats in the blood, reduce our HDL “good” cholesterol and increase blood pressure, all risk factors for CVD.
  • Quit smoking . Quitting smoking may be difficult, but doing so can greatly reduce the risk of CVD.

How is HRI fighting cardiovascular disease?

HRI conducts groundbreaking research across a broad range of cardiovascular-related topics, in our mission to reduce the number of people who die from CVD and to offer a better life for those already suffering from the disease by developing new treatments and medical devices.

Our Cardiovascular-protective Signalling and Drug Discovery Group is investigating how to repurpose existing drugs for next-generation CVD therapy.

Our Heart Rhythm and Stroke Prevention Group is investigating strategies to screen for atrial fibrillation in the general population, to prevent associated stroke.

Our Atherosclerosis and Vascular Remodelling Group aims to identify and gain insights from the genetic and molecular pathways involved in CVD.

  • World Health Organization; Cardiovascular diseases (CVDs) .
  • Australian Bureau of Statistics 2020, Causes of death 2019, cat. No. 3303.0, October
  • Australian Bureau of Statistics, 2018, National Health Survey: First results, 2017-18, ABS cat. No. 4364.0.55.001.
  • Australian Institute of Health and Welfare, Heart, stroke and vascular disease—Australian facts. Web report Last updated 30 June 2023.
  • Australian Institute of Health and Welfare; Living dangerously: Australians with multiple risk factors for cardiovascular disease; Feb 2005.
  • World Health Organization; Noncommunicable diseases (NCD) .

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Home — Essay Samples — Education — Health Education — The Importance of Heart Diseases


The Importance of Heart Diseases

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Published: Mar 20, 2024

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116 Heart Disease Essay Topic Ideas & Examples

🏆 best heart disease topic ideas & essay examples, 👍 good essay topics on heart disease, ⭐ simple & easy heart disease essay titles.

  • Congestive Heart Failure Etiology and Treatment Introduction Congestive heart failure (CHF) is a “progressive and debilitating disease” that is characterized by the congestion of body tissues (Nair & Peate, 2013, p. 237). Five percent of all medical admissions in hospitals are due to CHF. When an individual has this disease, his or her heart is not able to pump adequate blood […]
  • Sampling Methods in Nursing Study on Heart Failure In systematic sampling, the arrangement of the people was done in the order of their increase in age and selection using the same order.
  • Analysis of Coronary Heart Disease In such a manner, the delivery of blood with oxygen and nutrients to the whole body is timely and undisrupted, which guarantees the healthy functioning of the whole physiological system.
  • Hypertension and Congestive Heart Failure In conclusion, the patient experiences a range of issues related to hypertension, which is likely to cause left-sided congestive heart failure since it is the most common in the population.
  • Heart Diseases in Florida: Cardiology The Centers for Disease Control in Florida encourages the management of heart ailments and dementia in all the regions and Districts of Florida.
  • Heart Attack: Cellular Functions and Problems The story describes the symptoms and processes in the body of a man who suffered a heart attack. A heart attack directly impacts the cellular processes in the organism.
  • Coronary Heart Disease Caused by Stress It is essential to study the degree of influence of stress on the development of coronary heart disease since, in this way, it will be possible to prevent it more successfully.
  • Antioxidants: The Role in Preventing Cancer and Heart Disease Some of antioxidants are more widely known as vitamins E, C, and carotenoids, and have a reputation of preventing cardiovascular diseases and cancer.
  • Obesity and Coronary Heart Disease As shown in Table 1, the researchers have collected data about the rate of obesity and CHD in the chosen group.
  • COPD, Valvular Disease, and CHF: Risk of Heart Disease Under these conditions, it is possible to analyze the case regarding the high risks of chronic obstructive pulmonary disease, valvular disease, and congestive heart failure.
  • Epidemiology of Heart Disease Among Canadians At the end of the study, the connection between heart disease epidemiological evidence, community strategies, and internal and external impacts will be revealed to contribute to a better application of knowledge.
  • Vitamin E for Prevention of Heart Diseases As experiments on the benefits of vitamin E show, ‘swimming’ is not always the key to a completely healthy life, in which the risk of a heart attack is reduced to a minimum.
  • Heart Failure and Chronic Obstructive Pulmonary Disease Respiratory: The patient is diagnosed with COPD and continues to smoke up to two packs a day. Psychosocial: The patient is conscious and able to communicate with the staff, informing them of his state of […]
  • Congestive Heart Failure Treatment Innovations The relevance of the problem of this disease for health care is conditioned by the prevalence of pathology and the high economic costs of its treatment.
  • Plan for Management of Patient with Schizophrenia and Heart Disease About 1% of the world’s population suffers from schizophrenia About 0. 7% of the UK population suffers from schizophrenia Schizophrenia can manifest any time from early adulthood onwards, but rarely when a person is below […]
  • Preventing Heart Failure: Case Study In addition to the signs of heart failure, Mrs. The use of oxygen through nasal cannulas reduces the load on the heart, and it is rational.
  • Importance of Dashboard in Heart Failure Preventing Thorough testing of the heart failure dashboard is essential to ensure its successful work and contribute to the reduction of the risk of hospitalization for heart failure.
  • Nutrition in Relation to Heart Diseases in African Americans While the causes of such an occurrence are varied, dietary and nutrition-based difficulties are one of the factors that can increase the risk of cardiovascular diseases among African Americans.
  • Analysis of Heart Failure: Diagnosis and Treatment The current paper examines the two types of HF – systolic and diastolic – and explains the differences between the varieties based on the case study.
  • Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services For example, during one of my interactions with the patient, I was asked whether the hospital had the policy to avoid face-to-face interaction during the pandemic with the help of video examinations.
  • Diets to Prevent Heart Disease, Cancer, and Diabetes In order to prevent heart disease, cancer, and diabetes, people are required to adhere to strict routines, including in terms of diet. Additionally, people wanting to prevent heart disease, cancer, and diabetes also need to […]
  • Reducing Risks of Heart Diseases In recent years, the health of US citizens has been especially alarming: obesity and heart disease top the list of the most common causes of death, and the situation needs to be changed radically.
  • Critiquing Research: Fatigue in the Presence of Coronary Heart Disease Fatigue is a common and debilitating symptom linked to a number of acute and chronic conditions such as chronic heart failure and acute myocardial infarction. Fatigue has not been analyzed in regards to patients with stable coronary heart disease (CHD), despite the fact that it might factor into new onsets or progression of CHD. Therefore, […]
  • Hypertension and Risk of Heart Failure Therefore, it is essential to reduce the circulating volume with the help of diuretics, a low-sodium diet, and ACE inhibitors that block the activation of the RAAS.
  • Cardiomyopathy Types, Treatment, and Consequences Cardiomyopathy is a disease associated with a gradual increase in the volume of the left ventricle and, as a consequence, resulting in the formation of heart failure.
  • Impact of Cognitive Dysfunctions on Patients With Heart Failure Based on the statement, which has been the initial assumption, impaired cognitive functions correlate with a lack of participation in the treatment of heart failure. The frame in which the structural concepts of the research […]
  • American Heart Association on Coronary Artery Disease Coronary artery disease is a type of disease during which plaque accumulates in the blood vessels, restricting blood flow to the heart.
  • Heart Failure: Prevent Readmissions and Noncompliance With Chronic Management The Heart failure (HF) is a rising healthcare burden which is common among many admitted patients. The project will introduce preventive interventions and measures for HF.
  • Congestive Heart Failure: Diagnosis and Treatment Congestive Heart Failure is a condition characterized by decreasing pumping capacity of the heart muscles of a person resulting in the congestion of the body.
  • Heart Disease: Population Affected- Brooklyn Brooklyn leads in morbidity of heart diseases in comparison to the rest of New York and the United States in general.
  • IoT-Based Heart Attack Detection and Alert System The patient’s chest pain complaint mirrored against the prevailing hypertensive state, the elevated cholesterol levels, the chronic tobacco smoking, a high sodium diet, and inadequate physical activity.
  • Heart Failure: Diagnosis and Pharmacologic Treatment In addition, due attention should be paid to effective strategies for the prevention of symptoms and treatment of concomitant diseases to improve the quality of life of patients with heart failure.
  • The Different Types of Heart Failure Right-sided heart failure occurs when the right chamber of the heart has not enough power to pump blood to the lungs. The role of a nurse is to assess and educate a patient with heart […]
  • Pathophysiology of Congestive Heart Failure Cardiac output and stroke volume is lowered due to vasoconstriction. It causes pressure overload, which leads to congestion.
  • Congestive Heart Failure (CHF): Causes, Treatment and Prevention Congestive Heart Failure is a condition that occurs when the heart is unable to pump enough blood to meet the needs of the entire body.
  • Aspirin and Heart Attacks Relations Research studies have demonstrated aspirin is the recommended drug for secondary prevention of heart attack and other cardiovascular diseases. 2Research studies have demonstrated that aspirin is effective in the secondary prevention of cardiovascular diseases.
  • Health Issues of Heart Failure and Pediatric Diabetes As for the population, which is intended to participate in the research, I am convinced that there is the need to specify the patients who should be examined and monitored.
  • Systolic and Diastolic Heart Failure Second, the high sinus rhythm indicates the man’s irregular heartbeat, which is the result of the emergence of the specified event, and it is referred to as cardiac arrhythmias.
  • Chronic Obstructive Pulmonary Disease, Hypertension, and Heart Failure: The Case Study The most likely cause of the symptom is fluid accumulation and congestion in the pulmonary system due to the failed heart that reduces the kidneys’ perfusion, thus causing an increase in the production of renin.
  • Prevention of Heart Failure Hospital Readmissions This paper describes on improving patient’s health literacy and providing specialized nursing care will prevent heart failure hospital readmissions.
  • Readmission in Hypertension and Heart Failure Patients In research, the independent variables are presented by CHF interventions, mortality rates, and population size, whereas the dependent variable is the possible results of their use for people with PH.
  • Heart Disease Among Hispanic and Latino Population Hispanics and Latinos have the highest propensity for heart related diseases in the society. They are at a very high risk of developing diabetes, obesity, and hypertension.
  • The Role of Education in the Treatment of Congestive Heart Failure Home treatment plan is critical for the treatment and management of congestive heart failure, which is experienced by Mr.P. Hence, comprehensive education is central to the treatment and management of the congestive heart failure in […]
  • Hospital Readmission and Health Related Quality of Life in Patients With Heart Failure The article analyzes the treatment of patients and the bettering of care. And the third is the discharge itself and the plans that organize its carrying out.
  • Cardiology: Women and Heart Diseases Myocardial infarctions, also referred to as heart attacks, are some of the most dangerous cardiovascular diseases making a significant contribution to the mortality of the American population and imposing a great financial burden on the […]
  • Heart Disease and Stroke in Sarasota County Adults in Sarasota County must be informed of healthy lifestyles that reduce the risk of contracting cardiovascular diseases such as heart disease and stroke.
  • Chronic Heart Failure: Symptoms and Self-Management Finally, the other cause of CHF includes endocarditis or myocarditis, a condition that affects the heart valves or the muscles of the heart.
  • Coronary Heart Disease: Review One of the major concerns worth considering is the issue of aspirin failure. In summary, aspirin failure is a symbol of increased risk to coronary heart diseases.
  • Risk Factors Involving People with Ischaemic Heart Disease: In-Depth Interview In the following account of research on ischaemic heart disease, the researcher conducts qualitative research and qualitative analysis of the data obtained to determine the cause of the disease.
  • Left-Sided Heart Failure and Nursing Intervention Thus left-sided heart failure or left ventricular failure refers to a condition where the left part of the heart is unable to propel adequate oxygenated blood from the pulmonary transmission to the body through the […]
  • Congestive Heart Failure – One of the Most Devastating Diseases Based on the guideline, the study will be focused on all aspects in the management of CHF. This is a very efficient theory in addressing nursing issues and more precisely the management of CHF.
  • Home Health Care vs. Telemonitoring: Reducing Hospital Readmissions for Patients With Heart Failure In the United States, chronic heart failure is regarded as the number one cause of both the hospitalization and readmission of patients.
  • Coronary Heart Disease Aggravated by Type 2 Diabetes and Age In the case, the patient shows multiple signs associated with the coronary heart disease, which is associated with shortness of breath, irregular heartbeats, faster heartbeats, fatigue, and hypertension. A possible backward failure in the right […]
  • Heart Disease in New York State For those residing in New York, one of the most populous and metropolitan states in the United States, the cardiovascular disease presents one of the most serious threats.
  • Why the Elders Delay Responding to Heart Failure Symptoms The paper would discuss the reasons the elderly delay in responding to the symptoms of heart failure. It incorporates the history of the problem and seeks to use the current technology to solve the problem.
  • Heart Disease and Low Carbohydrate Diets My opinion about the connection between heart diseases and low-carb diets is based on the article written by Sacks and his team for the Journal of the American Medical Association in 2014 where the authors […]
  • Heart Disease: Cell Death During Myocardial Infarction This process is known as the non-reversible cell injury because of the changes in the cell structure and functions when the cell membrane is damaged, and the cell dies.
  • Intervention of Heart Diseases in Children The resources that are necessary for the program include the human resources: the governing body of the school, several teachers and parents willing to promote the program, health consultants.
  • Remote Care Costs for Congestive Heart Failure Various aspects of the article including the significance of the chosen problem, methods, and approaches, the reliability of results and the articles structure will be discussed and evaluated.
  • Identification and Assessment of Heart Disease Heart diseases have always been of primary concern for the population of the United States of America. The identification of heart diseases in the elderly can be rather a challenge due to the variety of […]
  • Heart Disease Among Hispanic & Latino Population One of the causes of the rise in the case of heart diseases in Westminster is the literacy rate of the Hispanic/Latinos in the county.
  • Heart Failure: Prevention of the Disease Heart failure is now occurring in younger people and it is vital to make them cautious and have a healthy lifestyle to prevent the disease. The purpose of the leaflet is to draw people’s attention […]
  • Prevention of Heart Disease and Stroke in Collier County According to the statistical data, presented by the Health Planning Council of Southwest Florida, these health problems are among the leading causes of death in this particular community. This strategy is helpful for understanding various […]
  • Understanding Cardiomyopathy in the Elderly There are different types of cardiomyopathy diseases, but the one that prevails among the elderly is restrictive cardiomyopathy, according to the National Institutes of Health. Dilated cardiomyopathy is most prevalent in Africa, mainly due to […]
  • Cardiomyopathy in the Elderly Patients Lack of flexibility of the ventricles due to stiffening affects the ventricle’s role of pumping blood out of the heart to other parts of the body or lungs.
  • Pharmacokinetics and Pharmacodynamics: Coronary Heart Disease Consequently, an increase in the doze of the drug followed, which was quite a predictable step for the healthcare specialist to take, and a sharp rise in Tina’s blood pressure ensued.
  • Congestive Heart Failure Case Management Program A multidisciplinary strategy can be observed and applied to the outpatient’s supervision of the CHF conditions with the attempt to facilitate the functionality and to bring down the statistics of readmission of the CHF patients […]
  • Therapeutic Properties of Fish Oil: Reduction of Heart Diseases The sudden reduction in deaths resulting from cardiac diseases led to the increased interest in the potential anti-arrhythmic properties of fish oil. The researchers hypothesized that the use of fish oil causes a significant reduction […]
  • Cardiomegaly: Symptoms, Types, Diagnosis, Treating The enlargement is caused by the extra job that the heart has to do to pump blood to the whole body. Mild cardiomegaly is described as a slight increase in the size of the heart.
  • Heart Attack: Causes and Prevention There is actually a way to escape the effect of this much dreaded disease and yet every year it claims the lives of thousands of people in the United States alone.
  • Social Determinants of the Heart Disease Cardiovascular diseases are injuries of the heart, blood vessels and the system of the blood vessels, the major reason for this is the accumulation of fats in blood vessels which interferes with the normal rate […]
  • Heart Hemodynamics and Cardiomyopathy The heart is the main organ responsible for the transport of blood, which in turn is carrying nutrients and other essential things that are needed in order for the body to function perfectly.
  • Cardiovascular Physiology: Interval Training in a Mouse Model of Diabetic Cardiomyopathy The abstract does not describe the study and the results accurately. The authors did not give enough details of the study in the abstract.
  • Heart Attack: Health Education and Intervention Methodologies According to the National Heart Lung and Blood Institute, “A heart attack occurs when blood flow to a section of the heart muscle becomes blocked.
  • Breathlessness as an Element of Congestive or Chronic Heart Failure It was done in order to preserve the focus of the analysis on the factor of breathlessness itself. The article allows nurses and other medical specialists to gain a more in-depth understanding of breathlessness among […]
  • The Syndrome of Chronic Heart Failure Chronic heart failure is a syndrome of various diseases of the cardiovascular system, leading to a decrease in the pumping function of the heart, chronic hyperactivation of neurohormonal systems.
  • Obstructive Sleep Apnea and Heart Diseases In children with Down syndrome, incidence rates of hypertension and sleepiness are high, and the problem is compounded in the presence of OSA.
  • Measures to Avoid Re-Hospitalization of Patients With Congestive Heart Failure The idea of this project is to print out a supplement for the hospital’s 28-page guide in English and Spanish, which will have the essential recommendations and references to page numbers.
  • Patient Education: Congestive Heart Failure These statistics suggest that hospitals have a substantial number of patients with CHF, and adjusting their practice and guidelines to suit the requirements of these patients is a necessity.
  • Heart Diseases: History, Risks and Prevention This may be attributed to the fact that most of the risk factors are as a result of our day to day activities.
  • Nutrition for People With Hearth Disease Studies have shown that the soluble fiber lowers cholesterol and decreases dietary fat absorption in the intestines. 13 mm Hg and in diastolic blood pressure of 1.
  • Congestive Heart Failure and Coronary Artery Disease The overall result of this is the development of a clump of fatty material covered by a smooth muscle and fibrous tissue on the inside of the artery; this is known as an atherosclerotic plaque.
  • Alcohol Consumption and Cardiovascular Diseases This is necessary to examine the relationship between individual experience of disease and consumption, and, in the population, is essential to the calculation of attributable risk.
  • Heart Diseases and Their Pathophysiology The primary pacemaker of the heart is the sinus node, a group of specialized cells located in the sulcus terminalis of the high right atrium, between the superior vena cava and the base of the […]
  • Chronic Diseases: Heart Failure and Cancer The first article examines the role of genetic testing of molecular markers that determine the occurrence and progression of cancer in individuals. The article recommends oncology nurses to keep abreast of advances in genomics for […]
  • Heart and Lung Diseases: Health History and Assessment J’s case that may lead to a heart attack include the following: Past heart attack. The patient was already administered to the intensive care unit with a decompensated heart failure.
  • Examining Pathophysiological Processes: Heart Failure & Chronic Kidney Disease Research conducted by Sahle concludes that the prevalence of HF in Australia is 1%-2%, which is similar to the statistics of the developed countries.
  • Combating Heart Disease in the African American Community of Kings County, NY Accordingly, people should be aware of the optimal parameters of a healthy person, and the popularization of physical activity, along with the correction of eating habits, can be a valuable way to achieve positive results.
  • Heart Attack: Health Information Patient Handout Heart attacks can be listed among the most dangerous health issues due to their ability to stop the work of the heart muscle.
  • Heart Disease, Risk Factors and Emotional Support As such, the objective of the study was to determine the effects of anger, anxiety, and depression on the development of cardiovascular diseases.
  • Chronic Heart Failure: Symptoms, Diagnosis, and Treatment The diagnosis of the condition is made when signs and symptoms of congestion along with reduced tissue perfusion are documented in the presence of abnormal systolic or diastolic cardiac function. When it comes to the […]
  • Heart Disease Reverse: Dr. Esselstyn’s Impact Esselstyn’s approach to improving the condition of a human heart and to reduce the number of heart attacks will be analyzed to develop several independent assertions about heart disease and rules to avoid coronary disease […]
  • Heart Disease: Causal Effects of Cardiovascular Risk Factors The process of cause and effect can be described as a relationship between issues where one is the outcome of the other.
  • Heart Disease and Alzheimer’s in Adult Women Education and Employment History: The patient reported she is a college graduate and has a master’s degree in Victorian Literature. The patient is currently working full-time as a Literature professor at UC Berkeley, in a […]
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IvyPanda. (2024, February 28). 116 Heart Disease Essay Topic Ideas & Examples.

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Heart Disease - Free Essay Examples and Topic Ideas

Heart disease refers to a range of conditions that affect the heart’s ability to function properly. These conditions may include issues with the heart’s blood vessels, valves, or rhythm. Heart disease is a leading cause of death worldwide, and common risk factors include a poor diet, lack of exercise, smoking, and high blood pressure or cholesterol. Symptoms of heart disease may include chest pain, shortness of breath, fatigue, and palpitations. Treatment options range from medications and lifestyle changes to surgery or other medical procedures, depending on the severity of the condition.

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Cardiovascular Diseases: Causes and Risk Factors

Cardiovascular diseases and wellness, cardiovascular disease in the contemporary world, personal significance, works cited.

Cardiovascular diseases refer to the ailments that affect heart and blood circulation. These diseases are the most common causes of death in the UK, especially among the older population (Bonow et al. 120). Physical inactivity, lifestyle of individuals and unhealthy diet are among the key factors that increase a person’s risk to suffer from cardiovascular ailments.

The most common cardiovascular diseases include coronary and congenital heart disease, blood vessels tumor, congestive heart failure, rheumatic heart disease, and deep venous thrombosis. The risk factors include old age, smoking, high blood pressure, obesity, and history of family heart disease.

The main causes of cardiovascular diseases are lifestyle choices such as smoking and obesity coupled with physical inabilities. In terms of physical wellness, cardiovascular disease patients experience tremendous physical strains in their bodies such as sudden chest aches, pain in one or both arms, and discomfort in their back, neck, and stomach.

Some experience squatness of breath, cold -sweat, nausea, and to some extent, lightheadedness. The main causal factor of these symptoms is their minimal engagement in leisure-period physical activities. They come about due to the inability of the body to meet the demands that arise from the physical environment.

Cardiovascular disease affects the emotional wellbeing of individuals who suffer from the condition. Depression is the most common emotional characteristics of cardiovascular disease. According to Elliott et al. (2011), symptoms who have this condition also exhibit signs of low self-esteem, anxiety, and they also have poor interpersonal skills (264).

Thus, such symptoms coupled with the ideologies that the patients have play a significant role in determining the effect that the treatments that have been administered to them will have on their health. Under such conditions, the patients usually consider that their situation is not likely to get better. For instance, individuals who have suffered from a heart attack have a high risk of getting another heart attack (Elliott et al. 264).

In terms of spiritual wellness, cardiovascular disease is associated with various spiritual atrophies, such as a feeling of anxiety, loss of meaning to life due to self-judgment, self-condemnation and conflicting values concerning ones physical wellbeing. Furthermore, there is a feeling of acting in rush so as to tackle the risks often without methodologies that are recommended.

The negative feelings of deep sadness, intense anger, and fear create the setting for emotional, physical, as well as mental-health dysfunction. Hence, the refutation of the profundity of distress only increases the condition and may result in serious heart failures and illnesses. Such feelings comprise risk factors that are similar in intensity to effects of high cholesterol or diabetes (Elliott et al. 270).

Currently, cardiovascular disease is caused by comparable factors affecting climate change. The World Health Organization has adopted approaches in dealing with this interrelationship (Kivimäki 1400). Climate extremes are turning out to be more and more common, and as a result placing greater strains on individual’s hearts.

A research conducted by the British Medical Journal revealed that every 1C of temperature change on a particular day is associated with 200 additional heart attacks (Kivimäki 1420). Heat waves have considerably increased in magnitude and intensity due to higher temperatures, and as a result, there has been an increase in cardiovascular related deaths like heart attacks.

For my part, I feel that in trying to tackle the health and wellbeing of people from cardiovascular disease epidemic is to offer actionable information that will lead to the development and execution of suitable policies. This should involve not just taking breaks from heavy workloads, but also more substantial but practicable dietary enhancements. Secondly, I try to engage in moderate physical activities such as walking and playing tennis every day as a means of relieving pressures that they face in life. In terms of emotional wellbeing, I try to make rational decisions while seeking family and friends console whenever necessary.

Bonow, Richards, Mann Daniels, Zipes Lopez, & Libby Peters. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. London: Elsevier Health Sciences, 2012. Print

Elliott, Patric, Lambiase, Davidson, & Kumar, Diha. Inherited Cardiac Disease. Oxford: Oxford University Press, 2011. Print.

Kivimäki, Michael. ‘Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data.’ The Lancet , 380.1 (2010): 1491 – 1497. Print

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StudyCorgi. (2020, May 5). Cardiovascular Diseases: Causes and Risk Factors.

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A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?

1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

2 Department of Medicine, Greater Baltimore Medical Center, Baltimore, MD, USA

L Nedda Dastmalchi

3 Division of Cardiology, Temple University Hospital, Philadelphia, PA, USA

Martha Gulati

4 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, LA, USA

Erin D Michos

5 Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Purpose of Review

The relationship between cardiovascular health and diet is evolving. Lifestyle modifications including diet changes are the primary approach in managing cardiometabolic risk factors. Thus, understanding different diets and their impact on cardiovascular health is important in guiding primary and secondary prevention of cardiovascular disease (CVD). Yet, there are many barriers and limitations to adopting a heart healthy diet.

Recent Findings

Diets rich in fruits, vegetables, legumes, whole grains, and lean protein sources, with minimization/avoidance of processed foods, trans-fats, and sugar sweetened beverages, are recommended by prevention guidelines. The Mediterranean, DASH, and plant-based diets have all proven cardioprotective in varying degrees and are endorsed by professional healthcare societies, while other emerging diets such as the ketogenic diet and intermittent fasting require more long-term study. The effects of diet on the gut microbiome and on cardiovascular health have opened a new path for precision medicine to improve cardiometabolic risk factors. The effects of certain dietary metabolites, such as trimethylamine N-oxide, on cardiometabolic risk factors, along with the changes in the gut microbiome diversity and gene pathways in relation to CVD management, are being explored.

In this review, we provide a comprehensive up-to-date overview on established and emerging diets in cardiovascular health. We discuss the effectiveness of various diets and most importantly the approaches to nutritional counseling where traditional and non-traditional approaches are being practiced, helping patients adopt heart healthy diets. We address the limitations to adopting a heart healthy diet regarding food insecurity, poor access, and socioeconomic burden. Lastly, we discuss the need for a multidisciplinary team-based approach, including the role of a nutrition specialist, in implementing culturally-tailored dietary recommendations. Understanding the limitations and finding ways to overcome the barriers in implementing heart-healthy diets will take us miles in the path to CVD prevention and management.

Plain Language Summary

The Mediterranean, DASH, and plant-based diets remain the leading heart healthy diets that match cardiology professional society recommendations. Emerging diets like the ketogenic diet and intermittent fasting are effective weight loss diets with unknown heart protective benefits, and require further studies on whether the benefits outweigh the risks. Adopting a heart-healthy diet is a foundational component for cardiovascular disease prevention, but barriers and limitations to adopting heart healthy diets exist and need to be assessed as part of cardiovascular risk assessment.


Despite the advances in medical management and evidence-supported dietary interventions for improved heart health, cardiovascular disease (CVD) remains the leading cause of death in the United States. 1 Over time, various diets have been studied for their effectiveness in CVD prevention. 2 One of the earliest epidemiological studies investigating the link between diet and CVD was the Seven Countries Study led by Ancel Keys between 1958 and 1964, which demonstrated that the myocardial infarction (MI) rate was lower in countries where fruits, vegetables, grains, beans, and fish formed the major part of the diet. 3 , 4 The INTERHEART Study then showed that 90% of MIs were due to preventable factors, with daily consumption of fruits and vegetables, along with regular physical activity, being associated with a 40% reduction in MI [Odds Ratio (OR)=0.60 (95% CI=0.51–0.71)]. 5 The Prospective Urban Rural Epidemiology (PURE) study conducted in over 130,000 individuals from 18 countries demonstrated that diets rich in fruits, vegetables, and legumes were associated with 19% lower risk of all-cause mortality [Hazard Ratio (HR)=0.81 (95% CI=0.68–0.96)] over 7-years of follow-up. 6

Lifestyle changes, including a heart-healthy diet, are the foundation of all CVD prevention guidelines. 7–10 The main cardiometabolic risk factors are diabetes, hypertension, dyslipidemia, and excess abdominal fat, which are all affected by dietary changes. 11 Unfortunately, there has been a worsening trend in CVD risk factors globally. 12 In the United States, the prevalence of type 2 diabetes (T2D) is 37 million adults, or 11% of the adult population, but an estimated 88 million US adults have prediabetes. 13 Globally, in 2021, 537 million individuals were affected by T2D, corresponding to 10.5% of the world’s population. 14 On a similar trend, the prevalence of controlled blood pressure, which had improved between 1999–2008, did not significantly change from 2007–2014, and then decreased after 2014. 15 Globally, between 1975 and 2016, the prevalence of obesity [defined in this study as a Body Mass Index (BMI) ≥25 kg/m 2 )] has tripled in adults. 16 In the US in 2017–2018, the age-adjusted prevalence of obesity (BMI ≥30 kg/m 2 ) among adults was 42% and severe obesity (BMI ≥40 kg/m 2 ) was 9%. 17 Increased visceral adiposity is a main driver of excess cardiometabolic risk, and increased abdominal waist circumference has become a CVD risk marker by itself. 18

Lifestyle modifications from exercise and dietary interventions have been well studied and proven effective toward CVD prevention and management. A healthy diet is one of the American Heart Association (AHA)’s “Life’s Essential 8” cardiovascular health metrics, which also include favorable levels of physical activity, sleep, nicotine exposure, BMI, blood lipids, blood glucose, and blood pressure. 19 However, <1% of US adults met “ideal” criteria for the AHA’s healthy diet metric in 2013–2014. 20

Diets rich in fruits, vegetables, legumes, whole grains, and lean protein sources, with minimization/avoidance of processed foods, trans-fats, and sugar sweetened beverages, are recommended by prevention guidelines. The Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and plant-based diets all have proven cardioprotective in varying degrees and are endorsed by professional healthcare societies, while other emerging diets such as the ketogenic diet and intermittent fasting require more long-term study. The effects of diet on the gut microbiome and on cardiovascular health have opened a new path for precision medicine to improve cardiometabolic risk factors. The effects of certain dietary metabolites, such as trimethylamine N-oxide (TMAO), on cardiometabolic risk factors, along with the changes in the gut microbiome diversity and gene pathways in relation to CVD management, are being explored.

In this review, we will provide a comprehensive up-to-date overview on established and emerging diets for cardiovascular health and CVD prevention. We will address the limitations to adopting a heart healthy diet from food insecurity, poor access, and socioeconomic burden. Lastly, we will discuss the need for additional nutritional education in health professional schools, and the importance of a multidisciplinary team to partner with patients to improve their nutritional knowledge and self-efficacy in adopting heart healthy diets.

Established Heart Healthy Diets

Three major dietary patterns (the Mediterranean diet, the DASH diet, and the healthy plant-based diet) ( Figure 1 ) have the most evidence for CVD prevention and are described below.

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The Heart Healthy Dietary Patterns: Mediterranean Diet, DASH Diet, and Healthy Plant-Based Diet.

The Mediterranean Diet

The Mediterranean diet, which was inspired by the eating habits of countries that border the Mediterranean sea (ie, Spain, Italy, and Southern Greece) is one that is rich in whole-grains, leafy green vegetables, fruits, legumes, unsalted nuts, herbs, spices, and extra virgin olive oil (EVOO), with a moderate intake of lean proteins such as fish and poultry, moderate alcohol consumption, and limited intake of red meat and sweets. By its very nature, the Mediterranean diet limits or eliminates many of the culprits in the standard American diet that drive CVD – saturated fat, highly processed refined grains and sugars, and red meat. 2 , 10 , 21 The Mediterranean diet differs from other dietary patterns as there is a greater emphasis on EVOO, nuts, reduced dairy consumption, and eating with family. 22 The Mediterranean diet has been found to be favorable as a food pattern, rather than single nutrient supplementation, as it inherently provides anti-oxidants, reduces inflammation of the vascular wall, modulates pro-atherogenic genes, alters gut microbiome, and improves lipid panels by decreasing low density lipoprotein cholesterol (LDL-C) and raising high density lipoprotein cholesterol (HDL-C). 21 , 23–25

Nutritional genomic studies show that greater adherence to a Mediterranean diet blunt the development of an adverse cardiometabolic phenotype in genetically susceptible individuals, with interactions between the Mediterranean diet and polymorphisms of the cyclooxygenase-2, interleukin-6, apolipoprotein A2, cholesteryl ester transfer protein plasma, and transcription factor 7-like 2 genes. 26 One study found that the Mediterranean diet plus EVOO prevented increases in levels of pro-atherothrombotic genes such as Cox-2, low-density lipoprotein receptor-related protein, and monocyte chemoattractant protein 1 expression compared to a control diet. 27

As mentioned above, the benefits of the Mediterranean diet were first appreciated in the Seven Countries Study (Yugoslavia, Italy, Greece, Finland, the Netherlands, Japan, and the US), led by Ancel Keys in 1958, who found there was a higher rate of mortality from coronary heart disease (CHD) in men from the US and Northern Europe in comparison to regions in Southern Europe. 3 , 28 The countries in southern Europe had higher consumption of olive oil, fruits, vegetables and fish, and lower consumption of meat and animal fats, in comparison to populations in the US and Northern Europe. These populations were also found to be leaner and had active lifestyles, a stark contrast from the US and Northern Europe populations who were mainly sedentary. 28 Prospective observational studies also found similar correlations, where persons living in Greece who reported higher adherence to the Mediterranean dietary pattern (per 2 point increment in Mediterranean diet score) were found to have a significantly lower risk of CHD death with an adjusted HR of 0.67 (95% CI=0.47–0.94) over an average of 44 months. 29 In another cohort of 15,482 patients who had stable CHD, higher adherence to a Mediterranean-style diet (per 1 unit increase in scores above 12) was independently associated with a 5% reduction in cardiovascular events over 3.7 years (HR=0.95; 95% CI=0.91–0.98). 30 Closer adherence to a Mediterranean-style diet has also been shown to be associated with a lower risk of preeclampsia. 31

Randomized controlled trials (RCTs) followed these epidemiological studies and have demonstrated the cardiovascular benefits of the Mediterranean style diet. The Lyon Diet Heart Study was a RCT that assessed whether the Mediterranean diet was beneficial in the secondary prevention of CVD among patients after a first MI. 32 The authors found a greater than 70% reduction in recurrent non-fatal MI and greater than 50% reduction in mortality in the group adhering to the Mediterranean diet, compared to a prudent diet control group, over a 4-year period. 32 , 33

The Prevención con Dieta Mediterránea (PREDIMED) trial was a RCT that aimed to assess the role of the Mediterranean diet for the primary prevention of CVD among 7,447 patients at elevated cardiovascular risk. 34 Participants were randomized to one of three diets: the Mediterranean diet with higher amounts of EVOO, the Mediterranean diet with higher amounts of nuts, or a standard diet that was low in fat, with dietary guidance. 34 After 4.8 years, there was approximately a 30% reduction in MI, stroke, or CVD death among those consuming the Mediterranean diet with EVOO (HR=0.69; 95% CI=0.53–0.91) as well as in the group consuming the Mediterranean diet with nuts (HR=0.72; 95% CI=0.54–0.95), compared to the low-fat diet. 34 Risk factors for CVD were also shown to benefit with Mediterranean diet intervention, with the incidence of diabetes being 52% lower (95% CI=27–86%) in the two pooled Mediterranean diet groups compared to controls. 35 In a biomarkers subgroup analysis, patients following the Mediterranean diet had reduction in N-terminal pro-B-type natriuretic peptide, and those on the Mediterranean diet with EVOO were found to have a reduction in oxidized LDL and lipoprotein(a) plasma concentrations, in comparison to those on the low fat diet. 36 Overall the PREDIMED study was one of the groundbreaking trials to show that a Mediterranean diet rich in unsaturated fats and polyphenols can be useful for primary CVD prevention.

Further research has been done to understand why the Mediterranean diet is so valuable in reducing CVD risk. One meta-analysis of observational epidemiologic studies evaluated whether EVOO itself shows benefit in CVD. 37 Researchers found that a higher consumption of fats from EVOO had a reduced relative risk (RR) of 0.85 (95% CI=0.77–0.93) for CVD and of 0.83 (95% CI=0.77–0.90) for all-cause mortality. The researchers believed that the anti-inflammatory and antioxidant effects play a role through its abundance of phenolic compounds and vitamin E with the addition of substituting saturated fats from the diet with monounsaturated and polyunsaturated fats. 37 Additionally, the anti-inflammatory properties of EVOO play a role in reducing platelet aggregation. 21 The emphasis of high fiber foods, such as whole grains and vegetables, in the Mediterranean-style diet provides benefit in the gut microbiome. 38 With improvement in the biodiversity of the gut microbiome (as discussed further later in this review), beneficial effects of blood pressure control, reduction in metabolic syndrome and diabetes, lower levels of pro-atherogenic compounds, and ultimately lower rates of CVD have been demonstrated. 39 Red meat, which is minimized in the traditional Mediterranean diet, contains the nutrient L-Carnitine, which produces the pro-atherogenic compound γ-butyrobetaine (γBB) as it gets converted to trimethylamine and TMAO by the gut microbes, both of which accelerate atherosclerosis. 40 These favorable elements of the Mediterranean dietary pattern are further enhanced by the emphasis of physical activity, which has shown to improve cardiometabolic health and reduce CVD. 21

The DASH Diet

The DASH diet was created in 1997 by the National Heart Lung and Blood Institute to prevent and treat hypertension, a known risk factor for CVD. 41 The DASH diet is rich in fruits and vegetables, low-fat dairy, whole grain, poultry, fish, nuts, and seeds, while limiting fatty meats, sweets, sugar sweetened beverages, and full-fat dairy products. 42 The standard DASH diet restricts salt consumption to 2,300 mg per day. It meets the Dietary Guidelines for Americans’ recommendation of limiting daily salt consumption to less than 2,300 mg. A reduced-sodium version of DASH limits sodium intake to 1,500 mg per day. Significant reduction in cardiometabolic risk is seen with the DASH diet by lowering blood pressure, total cholesterol, and LDL-C, all of which are significant risk factors which are accounted for in the atherosclerotic CVD (ASCVD) risk score and eventually leads to improvement in cardiac function and decreased incidence of diabetes. 43–46 One of the main key elements of the DASH diet in lowering blood pressure is the sodium restriction in comparison to other diets. 41 , 42 , 46

A DASH diet has been shown to reduce blood pressure in persons with or without hypertension, where in an RCT, the DASH diet reduced blood pressure by 5–6 mmHg systolic and 3 mmHg diastolic, while also lowering LDL-C by 11 mg/dL. 41 In observational data, a DASH-style dietary pattern has also been associated with a lower risk of CVD, heart failure, and diabetes. 47 , 48 In the Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO) RCT, 92 individuals, 41% women, with non-obstructive coronary atherosclerosis were randomized to either DASH diet with optimal medical therapy or control group of just optimal medical treatment. 49 At a mean of just 67 weeks, a significant reduction in noncalcified plaque in the DASH diet intervention group was found in comparison to the medical treatment alone group. 49

The Healthy Plant-Based Diet

A healthy plant-based diet has been shown to be associated with lower cardiovascular risk. 50–55 Plant-based diets, a diet consistently of predominantly plants, can be diverse in content, patterns, and even have subsets. The subsets branch into vegetarian (which excludes meat, poultry, seafood, and fish) and vegan (in which all animal food and their products are eliminated from the diet). Other plant-based diet subsets include lacto-vegetarians, who consume dairy products, lacto-ovo-vegetarians, who consume dairy and eggs, pesco-vegetarians or pescatarians, who consume fish, dairy, and eggs, and lastly, semi-vegetarians, who exclude red meats, possibly poultry as well.

These diets are assessed based on the vegetable content of the diet, but do not necessarily account for the sugar, fat, and sodium content, which can decrease the cardioprotective nature of a plant-based diet. 51 Indeed, unhealthy plant-based diets (such as those higher in refined grains, potatoes/fries, juices/sweetened beverages, sweets) may have similar CVD risk as animal-based diets. 51 The main foundation of a healthy plant-based diet is the whole grains, fruits, vegetables, nuts, and legumes with the low frequency and content of animal food. It has low energy density, with low saturated fats and high fiber content, which triggers early satiety cues and helps with digestion by delaying gastric emptying, with moderate insulinemic and glycemic responses. 56 , 57 Furthermore, studies have shown improved lipid profiles in individuals who follow a plant-based diet due to increased fiber intake, as fat absorption decreases overall. 58

Many studies examined this type of diet from different aspects using a pro-vegetarian diet score, which assigns higher scores to plant foods and negative scores to animal foods, or a similar plant-based diet index. In the PREDIMED trial in Spain, vegetarian diets were associated with lower cardiovascular mortality (HR=0.47; 95% CI=0.21–1.04 for highest quintile compared to lowest; p -trend=0.039 across quintiles). 59 In two combined observational cohorts of more than 200,000 male and female health professionals in the US, a higher plant-based diet index was inversely associated with incidence of CVD (HR comparing extreme deciles: 0.92; 95% CI=0.83–1.01; p -trend=0.003 across deciles), a relationship which was stronger for a healthy plant-based diet index (HR 0.75; 95% CI=0.68–0.83; p -trend<0.001). 51 In another cohort of young and middle-aged adults from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort followed for nearly 32 years, the highest vs lowest quintile of plant-based diet score (time-averaged) was associated with a 52% reduction in incident CVD (HR=0.48; 95% CI=0.28–0.81). 60

Furthermore, plant-based diets have low processed meat content or none. Preservatives found in processed meats such as nitrates and sodium contribute to blood pressure elevation, impaired insulin response, and endothelial dysfunction. 61 Substantial reductions in cardiometabolic modifiable risk factors, such as blood pressure, LDL-C, blood glucose levels, inflammatory markers, and unhealthy weight patterns, even with similar caloric intake, were seen in plant-based diets in comparison to omnivorous diets. 55 , 61–63 Thus, this type of diet has a great potential in CVD prevention. However, this diet tends to have lower vitamin B12, vitamin D, calcium, zinc, protein, and retinol in comparison to omnivorous diets; for example, those following a vegan diet may require additional supplementation with vitamin B12. 64

Reconciling the Healthy Diet Patterns and the Importance of Minimally Processed Food

The Mediterranean, DASH, and healthy plant-based diets have more similarities than differences. Each of these diets emphasize fruits, vegetables, legumes, nuts, and whole grains. Diets rich in fruits and vegetables have been shown to be associated with lower risk of CVD and mortality. 6 , 65 Increased whole grain consumption is also associated with lower risk of CVD and mortality. 66 Higher consumption of nuts has also been shown to be associated with lower CVD risk. 67

Eating minimally processed whole foods is an important component to all healthy diets, as consuming poor diet quality is one of the leading contributors to cardiometabolic disease globally. 68 , 69 Ultra-processed foods are high in refined carbohydrates, added sugars, saturated and trans fats, sodium, and possibly artificial colors, flavors, and preservatives, and have high energy density and glycemic load, which all contribute to increased cardiometabolic risk factors. They also tend to be highly palatable so that individuals eat more calories in total. 70 Furthermore, eating more ultra-processed foods can result in displacement of cardioprotective foods such as fruits and vegetables. In the Framingham Offspring Study, each additional serving a day of ultra-processed foods was associated with a 7% increased risk of incident CVD (HR=1.07; 95% CI=1.03–1.12). 70 Similarly, in another cohort from Spain, each additional serving/day of ultra-processed food was associated with 18% higher mortality (HR=1.18; 95% CI=1.05–1.33). 71 In controlled feeding trials comparing diets that were matched for total calories, sugar, fat, fiber, and macronutrients, participants allowed ad libitum food intake ate ~500 kcal/day on the ultra-processed diet vs an unprocessed diet, and body weight changes were correlated with dietary differences in energy intake. 72

Emerging or Controversial Diets

Additional emerging diet patterns have been studied for their impact on cardiometabolic risk; these are more controversial due to conflicting data regarding their net cardiovascular health benefits or insufficient data to determine their long-term cardiovascular benefits. Two of the more promising ones, the Keto Diet and Time-Restricted Eating (TRE), are discussed below.

The Keto and Other Very Low Carb Diets

The ketogenic (or “keto”) diet is generally characterized by intake of very-low carbohydrate (VLC), high fat, and moderate protein. The class ketogenic diet divided total daily energy intake to be 90% from fat, 7% from protein, and only 3% from carbohydrates. Since that time, other formulations of the ketogenic diet have been proposed to improve compliance, as well as other low or very low carbohydrate diets that generally follow similar patterns of high fat low carbs, but do not generate ketosis. VLC diets have been promoted for their effects on weight loss, improvement in insulin resistance, and glycemic control; however, the high fat diet can promote increases in LDL-C, particularly in the subset of individuals who are LDL hyper-responders, suggestive of latent genetic dyslipidemias. 73–75 This has limited the enthusiasm of many professional medical societies from endorsing its use. 73 , 75

The ketogenic diet emerged in the early 1920s as an anti-seizure intervention, but with medical innovation and the development of effective anti-seizure medication, the ketogenic diet is no longer used for management of epilepsy. 76 Throughout time the ketogenic diet has been revisited by many nutritionists and scientists to explore the ketosis state of the body. It has been found that antioxidants and anti-inflammatory functions of genes were activated by the beta-hydroxybutyrate (BHB) metabolite product of ketosis. 75 BHB has been found to reduce reactive oxygen species production mainly by activating the nuclear factor erythroid-derived 2-related factor 2 (Nrf2) which is the major inducer of detoxification genes. Furthermore, it is an endogenous inhibitor of class I and class IIa histone deacetylases which upregulates the transcription of detoxifying genes including catalase, mitochondrial superoxide dismutase and metallothionein 2. 77 In an open label non-randomized control study of the nutritional ketosis state of patients with T2D, reductions in diabetes medication use, hemoglobin A1c (HbA1c), and overall weight were seen after 1 year, while patients were being supported in a continuous care model. 78 Individuals with insulin resistance or diabetes cannot properly metabolize glucose in the blood, which makes excess carbohydrates intake unfavorable in terms of glycemic control, and as such, following a VLC diet helps improve glycemic control and HbA1c. 79 , 80 Other studies evaluating VLC diets in the management of obesity found it more effective than low fat diets in improvement in cardiometabolic risk factors. 80–83 Furthermore, increased satiety due to the high fat and protein content and possible effects of the ketones on the appetite was found in individuals following a ketogenic diet. 84

On the other hand, some of the adverse effects that limit adoption of the ketogenic diet are the increase in total cholesterol, LDL-C, non-HDL cholesterol, triglycerides, and total apoB, all of which increase the risk of CVD. 73 , 74 , 82 , 85 , 86 The effect of a ketogenic diet on LDL-C is inconsistent, 86 but some patients can have a very dramatic increase in LDL-C in response. This dramatic increase in LDL-C levels can possibly exacerbate development of hyperlipidemia if an underlying genetic predisposition is present. 87 Furthermore,a recent meta-analysis found the ketogenic diet conferred unfavorable effects on LDL-C, apoB, and total cholesterol in normal weight adults. 88 The potential deleterious effect on lipids needs to be considered carefully before initiating a ketogenic diet, especially for individuals at elevated CVD risk such as those with T2D, and lipid levels should be monitored in patients following a ketogenic diet. Theoretically, a plant-based, ketogenic diet that is low in saturated fats may limit these adverse consequences, but there are no trials examining this. Long-term data of the efficacy and safety of ketogenic diets are still lacking.

Intermittent Fasting/Intermittent Energy Restrictions

Intermittent fasting (IF) (also known as intermittent energy restriction) diets have different forms and patterns with three general goals: prolonged periods of fasting prompting a state of ketosis, decreasing oxidative stress, and feeding and circadian rhythm synchronization. 89 The IF strategy holds promise for cardiovascular health, but the evidence is still limited, and lacking long-term studies. 90–93 A recent systematic review of RCTs studied the cardiovascular health benefits of IF in comparison to continuous calories restriction; although IF was found to be more effective in weight loss, it was not clinically significant in reduction of cardiometabolic risk factors. 93 Benefits on the molecular and cellular level of improved mitochondrial health, DNA repair, autophagy, and promotion of stem cell-based regeneration were found in laboratory mice. 94 Reducing oxidative stress is thought to decrease mitochondrial energy production and in return free radical production leading to reduced overall inflammation. 95 Alternatively, the reduction in weight and, hence, cardiometabolic risk factors with IF type diets may simply be the result of fewer total calories consumed given the reduced/restricted hours of feeding.

There are two main patterns of IF: alternate day fasting (ADF) and time restricted eating (TRE). TRE limits consumption of calories to a certain window of time each day, usually a 6–10 hour period. The ADF pattern is having a fast day followed by a feast day. A systemic review and meta-analysis on whether ADF helps with weight loss found the cumulative evidence suggests that ADF does reduce weight, BMI, and total cholesterol. 96 However, the studies were of short duration (<6 months long). In an RCT studying the effects of ADF in comparison to a calorie restricted diet or control diet on cardiometabolic risk factors, during a 1 year follow-up period of 6 months weight loss and 6 months maintenance, it was found that ADF was not superior to calories restriction in weight loss, weight maintenance, and reduction of cardiometabolic risk factors. 97

Regarding TRE, in a study of 139 individuals with unhealthy weight, no significant weight loss difference was found between individuals who adopted TRE with calorie restriction of 1,500 to 1,900 calories in comparison to calorie restriction alone (net difference=−1.8 kg; 95% CI=−4.0 to 0.4; P =0.11). 98 On the other hand, several studies have shown that TRE from a 6 to 10 hours window was effective in weight loss, cardiometabolic health enhancement, while maintaining muscle mass. 99–101 In one recent study of firefighters who have a shift-work occupation, researchers demonstrated that a 10-hour/day TRE window was feasible with improvement in cardiometabolic risk factors over 12 weeks compared to a standard feeding pattern. 102

Another pattern of TRE is one that is focused on aligning diet with the circadian rhythm with the aim to improve insulin sensitivity and weight loss. 103 Having feeding in sync with the circadian rhythm is hypothesized to optimize energy metabolism with the active and inactive phases of the circadian rhythm. Studies have shown that when the circadian rhythm is set (whether it be nocturnal or diurnal), TRE during the active phase has more health benefits and improved glucose tolerance with lower insulin levels needed. 104 For example, for a nocturnal rhythm, the active phase would be the dark time.

The Gut Microbiome and Heart Health

Lifestyle modifications of diet and exercise have been discussed extensively, but the relationship between cardiometabolic risk factors and the gut microbiome (the heart–gut axis) ( Figure 2 ) is an emerging area of study. 39 , 105 The gut microbiome is affected by dietary intake, antimicrobials, pre-and pro-biotics, and fecal microbial transplant, with potential impact on cardiovascular risk factors. For example, probiotics use has shown benefits in mild reduction in blood pressure, blood glucose, and TMAO levels. 106 Higher fiber intake is associated with increased diversity of the gut microbiota, 38 and a higher fiber diet is associated with lower risk of hypertension and CVD. 107

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The Heart–Gut axis (the role of the Gut Microbiome in Cardiovascular Health).

Individuals with hypertension were found to have altered microbial gut structure, function, and interaction. 108 While the autonomic nervous system plays a key role in regulating blood pressure, derangements in the gut microbiome triggers the release of inflammatory mediators and metabolites leading to neuroinflammation and increased blood pressure in return. 109 Furthermore, in resistant hypertension, researchers have found altered microbial pathways and metabolites that may drive the increase in blood pressure and be potential targets for new therapeutic approaches in hypertension management. 110 Additionally, certain dietary metabolites, such as TMAO, that are found in red meat, poultry, and fish, have been associated with increased risk of CVD. 111 TMAO have been linked to kidney fibrosis and loss of function, heart failure, atherosclerosis, and vascular inflammation, as well as thrombosis through platelet hyper-responsiveness. 39 , 111 , 112 One of the dietary protein metabolites of the gut microbiota is phenylacetic acid, which is metabolized by the liver and converted to phenylacetylglutamine that activates adrenergic receptors and in return increases platelets responsiveness and aggregation. 112 Understanding the pathways and interactions of the gut microbiome with diet and medication will help direct precision medicine in CVD management to have specific dietary recommendations, and possibly microbiome targeted therapies.

Cardiology Professional Society Recommendations

The AHA dietary guidance statement to promote cardiometabolic health was most recently released in 2021. 113 Diet recommendations were also included in the 2019 American College of Cardiology (ACC)/AHA Primary Prevention of CVD Guideline. 7 These guidelines recognize that sedentary lifestyle and increased caloric intake has led to increased excess body weight, which is a modifiable cardiometabolic risk factor. Thus, adjusting energy intake and expenditure to achieve and maintain a healthy body weight was the first recommendation in the dietary guidance. 113 These guidelines recognize the importance of healthy dietary patterns, rather than focusing on individual foods or nutrients, and recommend healthy nutrition to begin early in life. 113

Additionally the AHA statement recommends eating plenty and a variety of colorful fruits and vegetables; 113 “eating the rainbow” is one such approach. 114 Leafy green vegetables, other vegetables, whole fruits rather than juice, and legumes can be consumed in all forms such as fresh, frozen, or dried, although canned fruit which often contains added syrups should be avoided. 115 The guidelines also recommend choosing whole grain foods and products over refined grains. Whole grains, or products made with 51% whole grains, are rich in fiber which help support healthy weight patterns, improve digestion, and decrease absorption of cholesterol and associated with lower CVD risk. 57 , 107

The AHA statement also recommends eating healthy sources of protein, predominantly plant-based such as legumes and nuts. 113 Non-fried fish and seafood intake is recommended given the high omega-3 fatty acid content, especially when it substitutes animal sources of red and processed meat or full-fat dairy products, with ~2 to 3 servings per week of fish being associated with lower CVD incidences. 113 , 116 Other sources of protein include the low-fat or fat-free dairy products which have been shown to have neutral or beneficial effects on CVD risk. 113 , 117 If poultry or meat is desired, the AHA guidelines recommend eating lean and unprocessed forms. Several studies showed increased CVD and mortality incidence with increased intake of red meats. 118–121 Increased saturated fats, heme iron content, and l-carnitine metabolites such as TMAO from red meat contribute to atherosclerosis. 121 , 122

The AHA statement recommends using liquid plant oils instead of tropical oils or partially hydrogenated fats. 113 The benefits of EVOO, which is high in monounsaturated fat, was reviewed in the Mediterranean diet section. Dietary unsaturated fats, that are found in liquid plant oils such as soybean, corn, safflower and sunflower oils, walnuts, and flax seeds have shown cardiovascular health benefits of reducing LDL-C and total cholesterol levels. 123 On the other hand, tropical oils like coconut and palm oils, animal fats like butter and lard, as well as hydrogenated fats raise LDL-C and total cholesterol levels. 124 , 125 Another source of healthy fats is intake of fish that is rich in omega-3 fatty acids, which may have benefits on triglycerides and overall CVD risk, although little effect on LDL-C. 123

There had been some conflicting studies about whether linoleic acid (LA), which is found in vegetable oils such as corn, sunflower, and soybean oils, has a harmful effect on cancer and cardiovascular risk. However the purported pro-inflammatory effects of LA and other omega-6 fatty acids have not been conclusively confirmed, with even some studies showing a reduction in inflammation. 126 Furthermore, a meta-analysis found higher intakes of LA to be associated with lower (not higher) risk of CVD 127 and, along with other evidence, an author of a review concluded that LA intake within the range recommended by AHA has no harms associated with it. 128 Another more recent systematic review confirmed the reduction in CHD, CVD, and all-cause mortality with LA, but a slight increased risk in cancer mortality was noted (RR=1.06; 95% CI=1.02–1.11). 129 Other meta-analyses have not confirmed an excess cancer risk with higher LA intake. 130 Laboratory studies suggest, at higher thresholds, LA does not have tumor-promoting effects and may even be beneficial. 131 , 132 Although a small increase risk in cancer cannot be definitely excluded, there is not sufficient evidence that higher intake of LA substantially increases risk for breast, colorectal, or prostate cancer risk and, thus, should not be specifically avoided. 132

The ACC/AHA prevention guidelines discussed reducing added sugars and minimizing sugar-sweetened beverages, 7 , 113 as added sugars have been associated with increased risk of T2D, obesity, and CVD. 133 , 134 Additionally, the AHA guidance is to choose or prepare foods with little or no added salt, and to choose minimally processed foods instead of ultra-processed foods. 7 , 113 As for alcohol intake, the guidelines do not support initiation of alcohol intake for cardio-protection, and to limit alcohol if one does choose to drink. 113 Although moderate alcohol intake of 1–2 glasses per day has been associated with low risk of CHD and ischemic stroke, 135 the evidence behind this is not strong, 135 and some data suggest any alcohol intake, even one glass, is associated with increased risk of atrial fibrillation. 136

Approaches to Nutrition Counseling in CV Health

With the vast number of dietary behaviors proven to benefit cardiovascular health, implementation of these patterns can be cumbersome. Studies show that, despite ~80% of CVDs being preventable by adopting a healthier lifestyle, healthy eating behaviors are low, and there are numerous barriers to implementing these recommendations. Healthcare professionals have adopted multiple methods, such as nutrition counseling, culinary medicine, food pharmacies, and inpatient nutrition, all of which have been evaluated as effective means to implement dietary changes to patients. 137–139 Nutrition counseling through cognitive or behavioral theory has been shown to be most effective in dietary behaviors, weight, and cardiovascular risk factors as it is a supportive process that helps set priorities, establish goals, and create an individualized plan. 138–140 Motivational interviews modeled through behavioral theory, with self-monitoring, meal replacements, and/or meal plans help create a method of self-care. Client-centered counseling techniques in the long-term have been shown to be beneficial in effective chronic disease prevention where one study showed improvement in blood pressure and salt intake. 138 , 140 As nutrition counseling by a dietitian is shown to be beneficial, group counseling is a modality that takes the elements of individual nutrition counseling into a larger population through group therapy or culinary medicine. 137 , 138

Culinary medicine is an evidence-based approach to healthy eating where there is an emphasis on health promotion and illness management through dietary regimens. 141 Food pharmacies are designed to increase public access to fruits and vegetables and fully integrate the concept of “food is medicine” into health care systems. 142 These centers address financial barriers, knowledge gaps regarding healthy eating, and cooking skills by prescribing fruits and vegetables to patients. Community outreach programs have been successful in dietary changes through education, group counseling, and culinary medicine. 143 One such outreach program, “Shop With Your Doc”, has been shown to help implement positive dietary changes by patients gaining knowledge on how to read nutrition labels, read ingredients, and how to choose fresh produce. 144 Using surveys, one study found that there was an improvement in fresh vegetable consumption and less waste after produce allocation and educational intervention in low income populations. 143 Using the skills from nutrition counseling and applying them to an interactive community model, where patients can gain skills and apply them to their daily routines, may help implement larger scale changes. 141 , 143 , 144

The outpatient and community programs may offer guidance from a physician, dietitian, and a health coach to assist in not only improved diet, but also improve lifestyle with exercise programs with stress management techniques. Similarly, inpatient dietary guidance can be a method to implement the importance of nutrition when patients may be amenable to lifestyle changes. 139 , 145 Studies support that patients are most vulnerable to lifestyle changes after a life altering event, such as an MI. 146 In response to the data supporting the importance of nutrition in treating and preventing CVD, there has been greater pressure from hospital institutions in providing nutritious meals to inpatients. 139 Public policies, such as the Healthy Food in Health Care initiative, have been placed to assist hospitals in obtaining local produce and reducing meat products on the menu to improve patient nutrition and decrease environmental impact. 147 Despite these efforts to improve hospital menus, the effect on dietary behaviors needs to be further studied.

Limitations and Disparities to Implementing Dietary Changes

There are many challenges, but also many opportunities, to implementing healthy heart eating patterns ( Figure 3 ).

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Challenges and Opportunities for Implementing a Heart Healthy Diet.

Some of the main challenges and barriers to behavior or diet change have to do with the compatibility of regimen with patient lifestyles, including social and cultural factors of socioeconomic status, lack of social support, and certain cultural values, all of which have to be taken into consideration when recommending dietary changes. All diet recommendations need to be considered in the context of social determinants of health and societal barriers that drive health inequities. 148–151 Underserved populations, ethnic minorities, gender, and sexual minorities have been found to have a higher incidence of CVD and suffer from greater mortality. 151 , 152 These same groups are also faced with social barriers that make it difficult to adhere to preferable dietary patterns to improve their cardiovascular health. Additionally, individuals of lower income have been shown to be less likely counseled on diet modifications for CVD prevention in a representative US sample. 153

“Food deserts” (or grocery areas that lack fresh produce), “food swamps” (with excess of ultra-processed poor quality foods), and food insecurity all are contributors to obesity and chronic disease. 150 , 154 , 155 Recent studies have shown that food insecurity is a growing problem in the United States. 156 As a result of the COVID-19 pandemic, food insecurity has tripled, with an even higher prevalence among US adults with an income below the poverty level. 156 In comparison to high and middle income families, persons of low socioeconomic class are more likely to under consume fruits, vegetables, and whole grains and instead consume highly processed meats and beverages. 143 The fluctuating nature of eating food insecurity causes has been found to increase insulin resistance, increase blood pressure, and lead to poor weight management, which ultimately increase CVD risk. 152 , 156 These groups of patients may also not be able to access health care or seek treatment, which could lead to undiagnosed cardiovascular risk factors; this trend has been seen in gender and sexual minorities. 152 Food insecurity thus may pose as a strong barrier to adhering to lifestyle interventions, thus social and political support to provide access is needed.

Opportunities remain for improvement. Community engagement, such as through faith-based organizations, has been demonstrated to be successful at promoting fruit and vegetable consumption, along with other preventive strategies. 157 Culturally relevant and language appropriate resources are needed to assist patients from diverse backgrounds in making healthier choices. Family meals eaten together can be an important factor for cardiovascular health promotion, especially with parental modeling of healthy behaviors such as intake of vegetables and fruits; companionship at mealtimes that establishes a positive atmosphere around meals has been associated with improved dietary quality. 158

Physicians and other healthcare professionals can be the greatest advocates for their patients and can help provide counseling and information to access foods. However, medical schools are lacking in nutrition education and on average provide 20 hours of nutrition education to medical students. 159 Additionally, there is little emphasis on counseling and teaching patients about diet and how to make foods on a budget while maintaining cultural appropriateness. In recent years, programs have been placed where students engage in community outreach and culinary medicine practices. 137 These programs help to improve confidence in the knowledge of nutrition and their ability to provide counseling. Improving the nutritional education of physicians and other healthcare professionals, working as part of interdisciplinary teams, can help improve partnerships with their patients in improving nutritional quality and dietary behaviors with the aim to reduce CVD. 159


The AHA highlights diet as one of “Life’s Essential Eight” to help promote cardiovascular health and avoid disease. The Mediterranean diet remains one of the most effective and recommended balanced diets for cardiovascular health promotion, followed by the DASH diet for hypertension prevention and management, and healthy plant-based diet with careful consideration to its sugar and salt content as well as nutrient deficiencies. Other emerging diets that are widely adopted for weight loss like the keto or VLC diets remain controversial on whether the benefits of weight loss outweigh potential adverse changes to the lipid profile for example, and whether IF patterns have additional cardiometabolic benefits beyond simply the reduction of total calorie intake. The effects of diet on the gut microbiome and the importance of the gut–heart axis may be the future of our cardiovascular dietary recommendations where precision nutrition guides precision prevention.

Funding Statement

Dr. Michos is funded by the Amato Fund for Women’s Cardiovascular Health at Johns Hopkins University and by an American Heart Association Award, Number: 946222. Dr. Gulati is funded by the Anita Dann Friedman Chair in Women’s Cardiovascular Medicine and Research, and by the Department of Defense (Award Number: W81XWH-17-2-0030).


ACC, American College of Cardiology; AHA, American Heart Association; ADP, Alternate Day Fasting; BMI, Body Mass Index; CVD, Cardiovascular Disease; DASH, Dietary Approaches to Stop Hypertension; HDL-C, High Density Lipoprotein Cholesterol; IF, Intermittent Fasting; LDL-C, Low Density Lipoprotein Cholesterol; MI, Myocardial Infarction; RCT, Randomized Controlled Trial; T2D, Type 2 Diabetes; TRE, Time Restricted Eating; TMAO, Trimethylamine-N-oxide; US, United States; VLC, Very Low Carbohydrate.

Unrelated to this work, Dr. Michos has served on advisory boards for Amgen, Amarin, AstraZeneca, Bayer, Boehringer Ingelheim, Esperion, Novartis, Novo Nordisk, and Pfizer. Dr. Gulati has served on advisory boards for Novartis and Bayer. The authors report no other conflicts of interest in this work.

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New study shows a relationship between heart disease and spontaneous loss of Y chromosome

by Boston Medical Center

Y chromosome

Researchers at Boston Medical Center (BMC) and Boston University (BU) Chobanian & Avedisian School of Medicine, in collaboration with an international team of scientists, shared findings from a new study published in the American Heart Association journal, Circulation: Heart Failure that explores a common cause of heart disease in older men called transthyretin cardiac amyloidosis (ATTR-CA).

The study examines the relationship between spontaneous loss of the Y chromosome (LOY), a condition in aging men where the Y chromosome is spontaneously deleted in blood cells , and ATTR-CA, a progressive disease that causes heart failure and death. The team found that men with a higher proportion of blood cells missing Y chromosomes have a higher ATTR-CA mortality rate, informing future treatment for patients with ATTR-CA. The study team included investigators from Columbia University, University of Virginia, and Osaka Metropolitan Hospital in Japan.

LOY is the most common acquired genetic mutation in men, with more than half of men in their early 90s having lost the Y chromosome in some of their blood cells according to the National Cancer Institute. While LOY has been associated with heart failure survival rates in large population studies, it has never been examined in relation to ATTR-CA. The current study suggests that men with ATTR-CA who have LOY in greater than 21.6% of their blood cells were 2.6 times more likely to not survive this form of heart disease.

"Our study suggests that spontaneous LOY in circulating white blood cells contributes both to the development of ATTR-CA in men and influences the severity of disease," said Frederick L. Ruberg, MD, Chief of Cardiovascular Medicine at BMC, Professor of Medicine at BU Chobanian & Avedisian School of Medicine, and lead researcher in this study. "Additionally, our study's findings indicate that elevated LOY may be an important reason why some patients do not respond to the ATTR-CA therapy that is typically effective."

Current treatments for ATTR-CA work well for many patients, but roughly 30 percent of patients do not respond to treatment, leading to hospitalization and death. Findings from this study support elevated LOY as a potential barrier to treatment response. The findings could one day inform a clinician's choice in designing a treatment course for a patient with ATTR-CA and high level of LOY in hopes of a more favorable health outcome. Additionally, the findings could lead to the development of new treatments for those with heart disease, including ATTR-CA.

"Our study team represents an international collaboration that sought to explore an association between a common blood disorder and ATTR-CA that has never been previously considered," said Ruberg. "We provide evidence that these two conditions may be related, supporting a new way of understanding how ATTR-CA progresses as well as how to develop new potential targets for treatment."

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Causes And Effects Of Coronary Heart Disease

Info: 2314 words (9 pages) Nursing Essay Published: 11th Feb 2020

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Ozempic and Wegovy Slash Kidney Disease Risks in People With Diabetes

In a recent study, health complications dropped by 24 percent in those taking semaglutide, the active ingredient in Ozempic and Wegovy.

Don Rauf

Often called a wonder drug for type 2 diabetes and obesity, semaglutide — the active ingredient in Ozempic and Wegovy — may significantly improve kidney function in people with diabetes who have chronic kidney disease .

New research results presented this week at the Annual Scientific Sessions of the American Diabetes Association (ADA) showed that semaglutide reduced the likelihood of major kidney disease–related events — specifically kidney failure, substantial loss of kidney function, and death from kidney or cardiovascular causes — in these patients by 24 percent.

“This is a patient population at high risk of severe kidney outcomes,” said Richard E. Pratley, MD , a study author and medical director at the AdventHealth Diabetes Institute Orlando, Florida, in a statement . “Despite existing treatment options, there is still a clear unmet need for this group. The findings from the trial have the potential to change the disease course of these high-risk patients and pave the way for new treatment strategies, offering hope to millions of patients globally.”

Risk of Death From Heart Attacks and Other Causes Dropped by 20 Percent

In this trial, which followed more than 3,500 people with type 2 diabetes and chronic kidney disease over an average of 3.4 years, people who took a weekly shot of semaglutide in addition to standard care experienced 18 percent fewer major cardiovascular events than those receiving a placebo. The risk of death from any cause was 20 percent lower in the semaglutide group.

Semaglutide Also Helped People Already Taking Other Drugs That Boost Kidney Health

In an analysis of 550 participants who were taking either SGLT2 inhibitors or a placebo, scientists found that semaglutide’s benefit was comparable with or without SGLT2 use.

“We can say that semaglutide reduced the risk of the major kidney outcomes in people with type 2 diabetes, irrespective of baseline SGLT2 inhibitor used,” said Katherine Tuttle, MD , a study author in the division of nephrology at the University of Washington in Seattle, during the ADA meeting presentation.

How Semaglutide May Help Kidney Disease

Study authors noted that semaglutide takers had an improved estimated glomerular filtration rate (a test that measures your level of kidney function) compared with the placebo group.

They also lost about nine pounds on average.

“Semaglutide works by mimicking a natural hormone, GLP-1, to slow stomach emptying, and by acting on hunger centers in the brain that lead to individuals feeling more full when eating, and therefore eating less and losing weight,” explains Robert Gabbay, MD , the chief scientific and medical officer for the American Diabetes Association.

But, he adds, “The mechanism of the drug’s effect on kidney disease is not entirely clear.”

Because extra weight pushes the kidneys to work harder and filter wastes above the normal level, Ty Diwan, MD , a transplant surgeon with the Mayo Clinic in Rochester, Minnesota, suspects weight loss to be a driving factor in improving outcomes.

“The study results help to emphasize the role that obesity plays in renal [kidney] disease and exemplifies how treatment of obesity, via medications or surgery, can potentially improve chronic renal disease,” says Dr. Diwan, who was not involved in the research.

Semaglutide Comes With Side Effects

While calling these new findings “exciting,” Alyssa Dominguez, MD , an endocrinologist with Keck Medicine of USC  in Los Angeles, offers a few words of caution about common side effects of semaglutide.

“Patients should be counseled about potential gastrointestinal adverse effects such as nausea, vomiting, and diarrhea,” says Dr. Dominguez, who was not involved in the study. People on these medications need to stay well-hydrated, she adds, and should contact their doctor if they experience serious side effects.

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

  • Mann J et al. Effects of Semaglutide With and Without Concomitant SGLT2 Inhibitor Use in Participants With Type 2 Diabetes and Chronic Kidney Disease in the FLOW Trial. Nature Medicine . June 24, 2024.
  • Feng X et al. CKD Prevalence Among Patients With and Without Type 2 Diabetes: Regional Differences in the United States. Kidney Medicine . January 2022.
  • Cardiovascular Disease and Diabetes. American Heart Association . April 2, 2024.
  • Game-Changing Medications for Kidney Disease and Type 2 Diabetes. National Kidney Foundation . March 21, 2023.


Transplant patients call for drug innovation

David Kornwolf in his kitchen with his medications.  (Suzanne Kreiter/The Boston Globe via Getty Images)

On your NPR station today

People who get an organ transplant must take immunosuppressants daily. These drugs can have serious side effects and can cause secondary diseases like diabetes and cancer. And yet, they haven't been updated in more than a decade. Why?

Ken Newell , transplant surgeon at Emory University Hospital. He served as president of the American Society of Transplantation from 2014 to 2015.

William Fitzsimmons , advisor to the Transplant Therapeutic Consortium. He has spent 29 years in the pharmaceutical industry including developing transplant drugs.

Also Featured

Genevieve Morgan , kidney transplant recipient from Portland, Maine.

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