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Risk of peripheral artery disease according to a healthy lifestyle score: The PREDIMED study

Autores: López Laguna, Nieves; Martínez González, Miguel Ángel; Toledo Atucha, Estefanía; Babio, N.; Sorli, J. V.; Ros, E.; Muñoz, M. A.; Estruch, R.; Lapetra, J.; Muñoz-Bravo, C.; Fiol, M.; Serra-Majem, L.; Pinto, X.; Gonzalez, J. I.; Fito, M. ; Basora, J. ; Aros, F. ; Ruiz-Canela, Miguel (Autor de correspondencia)
Título de la revista: ATHEROSCLEROSIS
ISSN: 0021-9150
Volumen: 275
Páginas: 133 - 140
Fecha de publicación: 2018
Background and aims: The PREDIMED (PREvencion con Dleta MEDiterranea) is a multicentre trial analyzed as a prospective cohort study. A total of 7122 participants (aged 55-80 years) at high risk of cardiovascular disease in the PREDIMED trial were recruited in 11 centres in Spain. The prevalence of subjects with type 2 diabetes was 50%. Our objective was to determine the contribution of lifestyle factors to the development of peripheral artery disease (PAD). Methods: Incident clinical PAD in relation to a healthy lifestyle 5-point score defined as adherence to a Mediterranean diet (MedDiet), moderate alcohol intake, regular physical activity, normal weight (BMI<25) and non-smoking was measured. Results: Eighty-seven incident PAD cases were diagnosed during a median follow-up of 4.8 years. Compared with participants with 0 or 1 healthy lifestyle factor, the multivariable hazard ratio for PAD was 0.65 (95% confidence interval (CI) 0.37 to 1.14) for 2 factors, and 0.40 (0.22-0.72) for 3 or more. Moderate alcohol consumption, non-smoking, physical activity and following a MedDiet were significantly inversely associated with PAD whereas no association was found for normal weight (BMI<25 kg/m(2)). PAD risk monotonically decreased with an increasing number of lifestyle factors, and the greatest reduction was found for a score combining moderate alcohol consumption, MedDiet and physical activity or non-smoking. The multivariable-adjusted population attributable risk percent for the combination of these 4 factors was 80.5% (95% CI: 21.3%-95.1%). Conclusions: Our results demonstrate that a simple healthy lifestyle score is associated with a substantially reduced risk of PAD in a high cardiovascular risk population with a high prevalence (50%) of subjects with type 2 diabetes. (C) 2018 Elsevier B.V. All rights reserved.