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Title: Risk of peripheral artery disease according to a healthy lifestyle score: The PREDIMED study
Authors: López-Laguna, Nieves
Martínez-González, Miguel A.
Toledo, Estefania
Babio, Nancy
Sorlí, José, V.
Ros, Emilio
Muñoz, Miguel Angel
Estruch, Ramon
Lapetra, José
Muñoz-Bravo, Carlos
Fiol, Miguel
Serra-Majem, Lluís 
Pinto, Xavier
González, José, I. 
Fito, Montse
Basora, Josep
Arós, Fernando
Ruiz-Canela, Miguel
UNESCO Clasification: 3206 Ciencias de la nutrición
Keywords: Peripheral artery disease
Healthy lifestyle
Mediterranean diet
Physical activity
Alcohol consumption, et al
Issue Date: 2018
Publisher: 0021-9150
Journal: Atherosclerosis 
Abstract: Background and aims The PREDIMED (PREvención con DIeta MEDiterránea) 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/m2). 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.
ISSN: 0021-9150
DOI: 10.1016/j.atherosclerosis.2018.05.049
Source: Atherosclerosis [ISSN 0021-9150], v. 275, p. 133-140
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