Background: The objective of this trial was to investigate how unhealthy nutritional habits influence the evolution of cardiovascular diseases. Design and methods: We studied 1218 rural, adult patients, aged 58 ± 15 years with cardiovascular risk or stage 1-2 hypertension over 24 months. All included patients went through a medical check-up which included also a detailed anamnesis. We monitored the lifestyle changes that they have made. Results: Among patients who had unhealthy nutritional habits we encountered more hard cardiovascular outcomes. 38 from the 1126 patients with unhealthy nutritional habits suffered stroke or myocardial infarction during this period. Conclusions: In this study we found evidence that lifestyle changes, especially healthy diet could have benefic effect on the evolution of cardiovascular diseases.