Nuts are nutrient-rich foods that contain many bioactive compounds that are beneficial for cardiovascular health. Higher consumption of nuts has been associated with a reduced risk of several
cardiovascular diseases (CVD) in prospective cohort studies, including
a 19% and 25% lower risk of CVD incidence and mortality, respectively, and a 24% and 27% lower risk of
coronary heart disease incidence and mortality, respectively. An 18% lower risk of
stroke mortality, a 15% lower risk of
atrial fibrillation, and
a 19% lower risk of total mortality have also been observed. The role of nuts in
stroke incidence,
stroke subtypes,
peripheral arterial disease and
heart failure has been less consistent. This narrative review summarizes recommendations for nuts by clinical practice guidelines and governmental organizations, epidemiological evidence for nuts and CVD outcomes, nut-containing dietary patterns, potential mechanisms of nuts and CVD risk reduction, and future research directions, such as the use of
biomarkers to help better assess nut intake. Although there are still some uncertainties around nuts and CVD prevention which require further research, as summarized in this review, there is a substantial amount of evidence that supports that consuming nuts will have a positive impact on primary and
secondary prevention of CVD.