Effects of the Mediterranean diet on the secondary prevention of cardiovascular diseases: a systematic review of randomised controlled trials.

Abstract

This systematic review aimed to summarise the current knowledge regarding the effects of the Mediterranean diet (MD) on the secondary prevention of cardiovascular diseases (CVDs). A systematic search was done on Web of Sciences, PubMed, Scopus, and Google Scholar databases until January 2025. The majority of the included studies (15 of 16 RCTs) supported the role of MD following in the secondary prevention of CVDs. According to the RCT results, the patients in the MD group had lower cardiovascular deaths, non-fatal myocardial infarction, and other events. They also had healthier lipid profiles and blood fatty acids, higher flow-mediated dilation and endothelial progenitor cell levels, and lower endothelial progenitor cells compared to a low-fat diet. However, both MD and control (low-fat diet) groups promoted similar decreases in blood pressure and body mass index. The findings of this review suggested that adherence to the MD could be beneficial in the secondary prevention of CVD.