Journal
ATHEROSCLEROSIS
Volume 275, Issue -, Pages 133-140Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2018.05.049
Keywords
Peripheral artery disease; Healthy lifestyle; Mediterranean diet; Physical activity; Alcohol consumption; Smoking
Funding
- official funding agency for biomedical research of the Spanish Government
- Instituto de Salud Carlos III (ISCIII) [RTIC G03/140, RTIC RD 06/0045]
- Instituto de Salud Carlos III (ISCIII) through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn)
- Centro Nacional de Investigaciones Cardiovasculares [CNIC 06/2007]
- Fondo de Investigacion Sanitariae-Fondo Europeo de Desarrollo Regional [04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462]
- Ministerio de Ciencia e Innovacion (Recursos y teconologia agroalimentarias) [(AGL)-2009-13906-C02, AGL2010-22319-C03, AGL2013-49083-C3-1-R]
- Fundacion Mapfre 2010
- Consejeria de Salud de la Junta de Andalucia [PI0105/2007]
- Public Health Division of the Department of Health of the Autonomous Government of Catalonia
- Generalitat Valenciana (Generalitat Valenciana Ayuda Complementaria (GVACOMP)) [06109, GVACOMP2010-181, GVA-COMP2011-151]
- Conselleria de Sanitat y AP
- Atencion Primaria (CS) [2010-AP-111, CS2011-AP-042]
- Regional Government of Navarra [P27/2011]
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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.
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