The Impact of Ramadan Fasting on the Cardiovascular System with Particular Emphasis on Myocardial Infarction Risk
DOI:
https://doi.org/10.12775/QS.2026.49.67793Keywords
Ramadan fasting, cardiovascular diseases, myocardial infarction, cardiovascular risk factors, cardiovascular incidentsAbstract
Introduction
Cardiovascular diseases (CVD) are the leading cause of death worldwide, with prevalence rising in aging populations. Ramadan fasting, practiced by over a billion Muslims annually, may influence cardiovascular health through changes in metabolism and lifestyle.
Aim of the Study
This study aims to assess the effects of Ramadan fasting on the cardiovascular system, with emphasis on the risk of myocardial infarction.
Materials and Methods
This is a narrative literature review of current studies examining the impact of Ramadan fasting on cardiovascular parameters such as glucose metabolism, lipid profile, blood pressure, and incidence of cardiovascular events.
Results
Most studies suggest that Ramadan fasting leads to favorable changes: improved lipid profile, lower blood pressure, and reduced inflammation. Fasting appears safe for individuals with stable cardiovascular disease under medical supervision. However, a slight increase in myocardial infarction cases has been noted after Ramadan in some subgroups, especially older adults and those with comorbidities like diabetes or hypertension.
Conclusion
Ramadan fasting may benefit cardiovascular health, but safety depends on individual risk factors. It should be avoided by patients with unstable heart conditions. Personalized assessment and increased awareness are key to safe fasting practices.
References
1. Roth GA, Mensah GA, Johnson CO, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study [published correction appears in J Am Coll Cardiol. 2021 Apr 20;77(15):1958-1959. doi: 10.1016/j.jacc.2021.02.039.]. J Am Coll Cardiol. 2020;76(25):2982-3021. doi:10.1016/j.jacc.2020.11.010
2. Chong B, Jayabaskaran J, Jauhari SM, et al. Global burden of cardiovascular diseases: projections from 2025 to 2050. Eur J Prev Cardiol. Published online September 13, 2024. doi:10.1093/eurjpc/zwae281
3. Akhtar AM, Ghouri N, Chahal CAA, et al. Ramadan fasting: recommendations for patients with cardiovascular disease. Heart. 2022;108(4):258-265. doi:10.1136/heartjnl-2021-319273
4. Hassanein M, Afandi B, Yakoob Ahmedani M, et al. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract. 2022;185:109185. doi:10.1016/j.diabres.2021.109185
5. Shaikh S, Latheef A, Razi SM, Khan SA, Sahay R, Kalra S. Diabetes Management During Ramadan. In: Feingold KR, Ahmed SF, Anawalt B, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; May 18, 2022.
6. Oueslati I, Cherif L, Aloui E, Mabrouk M, Yazidi M, Chihaoui M. Ramadan diurnal intermittent fasting in patients with diabetes: assessment of knowledge, practices, risk of complications, and impact of pre-ramadan education. J Diabetes Metab Disord. 2024;24(1):9. Published 2024 Dec 16. doi:10.1007/s40200-024-01529-w
7. Hammoud S, Saad I, Karam R, Abou Jaoude F, van den Bemt BJF, Kurdi M. Impact of Ramadan Intermittent Fasting on the Heart Rate Variability and Cardiovascular Parameters of Patients with Controlled Hypertension. J Nutr Metab. 2021;2021:6610455. Published 2021 Mar 29. doi:10.1155/2021/6610455
8. Akhtar P, Kazmi A, Sharma T, Sharma A. Effects of Ramadan fasting on serum lipid profile. J Family Med Prim Care. 2020;9(5):2337-2341. Published 2020 May 31. doi:10.4103/jfmpc.jfmpc_550_19
9. Shehab A, Abdulle A, El Issa A, Al Suwaidi J, Nagelkerke N. Favorable changes in lipid profile: the effects of fasting after Ramadan. PLoS One. 2012;7(10):e47615. doi:10.1371/journal.pone.0047615
10. Alsubheen SA, Ismail M, Baker A, et al. The effects of diurnal Ramadan fasting on energy expenditure and substrate oxidation in healthy men. Br J Nutr. 2017;118(12):1023-1030. doi:10.1017/S0007114517003221
11. Alayed KM. Glucagon-Like Peptide-1 (GLP-1) during Ramadan: Narrative Review of the Published Literature. J Obes. 2023;2023:8626081. Published 2023 Dec 26. doi:10.1155/2023/8626081
12. Tsitsou S, Zacharodimos N, Poulia KA, Karatzi K, Dimitriadis G, Papakonstantinou E. Effects of Time-Restricted Feeding and Ramadan Fasting on Body Weight, Body Composition, Glucose Responses, and Insulin Resistance: A Systematic Review of Randomized Controlled Trials. Nutrients. 2022;14(22):4778. Published 2022 Nov 11. doi:10.3390/nu14224778
13. Asadi H, Abolfathi AA, Badalzadeh R, et al. Effects of Ramadan Fasting on Serum Amyloid A and Protein Carbonyl Group Levels in Patients With Cardiovascular Diseases. J Cardiovasc Thorac Res. 2015;7(2):55-59. doi:10.15171/jcvtr.2015.12
14. Horne BD, Muhlestein JB, Anderson JL. Health effects of intermittent fasting: hormesis or harm? A systematic review. Am J Clin Nutr. 2015;102(2):464-470. doi:10.3945/ajcn.115.109553
15. Lessan N, Ali T. Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients. 2019;11(5):1192. Published 2019 May 27. doi:10.3390/nu11051192
16. Ojha N, Dhamoon AS. Myocardial Infarction. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 8, 2023.
17. Antza C, Gallo A, Boutari C, et al. Prevention of cardiovascular disease in young adults: Focus on gender differences. A collaborative review from the EAS Young Fellows. Atherosclerosis. 2023;384:117272. doi:10.1016/j.atherosclerosis.2023.117272
18. Heusch G, Gersh BJ. The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: a continual challenge. Eur Heart J. 2017;38(11):774-784. doi:10.1093/eurheartj/ehw224
19. Elendu C, Amaechi DC, Elendu TC, et al. Comprehensive review of ST-segment elevation myocardial infarction: Understanding pathophysiology, diagnostic strategies, and current treatment approaches. Medicine (Baltimore). 2023;102(43):e35687. doi:10.1097/MD.0000000000035687
20. Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, et al. Pathophysiology of Atherosclerosis. Int J Mol Sci. 2022;23(6):3346. Published 2022 Mar 20. doi:10.3390/ijms23063346
21. Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci. 2023;7(5):457-466. doi:10.1042/ETLS20230111
22. Gomes S, Ramalhete C, Ferreira I, Bicho M, Valente A. Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases. Nutrients. 2023;15(11):2462. Published 2023 May 25. doi:10.3390/nu15112462
23. Abu Dabrh, A. M., et al. (2022). Impact of Ramadan fasting on cardiovascular events: A retrospective population-based study. International Journal of Cardiology, 354, 58-64. https://doi.org/10.1016/j.ijcard.2022.02.034
24. Al-Mosawi, M. S., & Abbas, M. M. (2020). The impact of Ramadan fasting on acute coronary syndrome hospitalizations: A study from Iraq. Middle East Journal of Cardiology, 17(2), 105-111. https://doi.org/10.1097/MJBY.0000000000000120
25. Aljawadi, M., et al. (2021). Cardiovascular safety of Ramadan fasting in patients with coronary artery disease in Saudi Arabia. Journal of Saudi Heart Association, 33(3), 305-312. https://doi.org/10.37616/2212-5043.1240
26. Faris, M., et al. (2023). Seasonal variation in cardiovascular outcomes during Ramadan fasting. Journal of Clinical Lipidology, 17(1), 112-120. https://doi.org/10.1016/j.jacl.2022.11.005
27. Chamsi-Pasha M, Chamsi-Pasha H. The cardiac patient in Ramadan. Avicenna J Med. 2016;6(2):33-38. doi:10.4103/2231-0770.179547.
28. Nematy M, Alinezhad-Namaghi M, Rashed MM, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012;11:69. Published 2012 Sep 10. doi:10.1186/1475-2891-11-69
29. Mazidi M, Rezaie P, Chaudhri O, Karimi E, Nematy M. The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: A systematic review. Pak J Med Sci. 2015;31(5):1250-1255. doi:10.12669/pjms.315.7649
30. Betesh-Abay B, Shiyovich A, Davidian S, Gilutz H, Shalata W, Plakht Y. The Association between Acute Myocardial Infarction-Related Outcomes and the Ramadan Period: A Retrospective Population-Based Study. J Clin Med. 2022;11(17):5145. Published 2022 Aug 31. doi:10.3390/jcm11175145
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Liwia Olczyk, Laura Więcko, Katarzyna Trela, Aleksander Tuteja, klaudia Burzykowska, Kamila Geborys, Konrad Krupa, Rema Mohaissen, Mikołaj Tyla, Patryk Stabrawa
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 16
Number of citations: 0
