Risk of peripheral artery disease according to a healthy lifestyle score: The PREDIMED study Academic Article uri icon


  • 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.


  • López-Laguna, Nieves
  • Martinez-Gonzalez, Miguel A
  • Toledo, Estefania
  • Babio, Nancy
  • Sorlí, José V
  • Ros, Emilio
  • Muñoz, Miguel Ángel
  • Estruch, Ramon
  • Lapetra, José
  • Muñoz-Bravo, Carlos
  • Fiol, Miquel
  • Serra-Majem, Lluís
  • Pintó, Xavier
  • González, José I
  • Fitó, Montse
  • Basora, Josep
  • Arós, Fernando
  • Ruiz-Canela, Miguel

publication date

  • 2018

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