Impact of Life's Simple 7 on the incidence of major cardiovascular events in high-risk Spanish adults in the PREDIMED study cohort Academic Article uri icon


  • INTRODUCTION AND OBJECTIVES:The Life's Simple 7 strategy of the American Heart Association proposes 7 metrics of ideal cardiovascular health: body mass index (BMI) <25mg/m2, not smoking, healthy diet, moderate physical activity ≥ 150min/wk, total blood cholesterol <200mg/dL, systolic and diastolic blood pressures <120 and <80mmHg, respectively, and fasting blood glucose <100mg/dL. It is important to assess the combined effect of these 7 metrics in the Spanish population. We prospectively analyzed the impact of baseline Life's Simple 7 metrics on the incidence of major cardiovascular events in the PREDIMED cohort (57.5% women, average baseline age, 67 years). METHODS:The healthy diet metric was defined as attaining ≥ 9 points on a validated 14-item Mediterranean diet adherence screener. An incident major cardiovascular event was defined as a composite of myocardial infarction, stroke, or cardiovascular death. Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and their 95% confidence intervals (95%CI) for successive categories of health metrics. RESULTS:After a median follow-up of 4.8 years in 7447 participants, there were 288 major cardiovascular events. After adjustment for age, sex, center, and intervention group, HRs (95%CI) were 0.73 (0.54-0.99), 0.57 (0.41-0.78), and 0.34 (0.21-0.53) for participants with 2, 3, and ≥ 4 metrics, respectively, compared with participants with only 0 to 1 metrics. CONCLUSIONS:In an elderly Spanish population at high cardiovascular risk, better adherence to Life's Simple 7 metrics was progressively associated with a substantially lower rate of major cardiovascular events.


  • Díez-Espino, Javier
  • Buil-Cosiales, Pilar
  • Babio, Nancy
  • Toledo, Estefanía
  • Corella, Dolores
  • Ros, Emilio
  • Fitó, Montserrat
  • Gómez-Gracia, Enrique
  • Estruch, Ramón
  • Fiol, Miquel
  • Lapetra, José
  • Alonso-Gómez, Angel
  • Serra-Majem, Lluis
  • Pintó, Xavier
  • Sorlí, José V
  • Muñoz, Miguel A
  • Basora, Josep
  • Martínez-González, Miguel Á

publication date

  • 2019