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Andaluc\u00eda","award":["PROMETEO 21\/2021"],"award-info":[{"award-number":["PROMETEO 21\/2021"]}]},{"name":"Generalitat Valenciana, Spain","award":["RTIC G03\/140"],"award-info":[{"award-number":["RTIC G03\/140"]}]},{"name":"Generalitat Valenciana, Spain","award":["RTIC RD 06\/0045"],"award-info":[{"award-number":["RTIC RD 06\/0045"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI04\/0233"],"award-info":[{"award-number":["PI04\/0233"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI05\/0976"],"award-info":[{"award-number":["PI05\/0976"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI07\/0240"],"award-info":[{"award-number":["PI07\/0240"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI10\/01407"],"award-info":[{"award-number":["PI10\/01407"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI10\/02658"],"award-info":[{"award-number":["PI10\/02658"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI11\/00049"],"award-info":[{"award-number":["PI11\/00049"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI11\/02505"],"award-info":[{"award-number":["PI11\/02505"]}]},{"name":"Generalitat Valenciana, Spain","award":["AGL 2010-229-C03-03"],"award-info":[{"award-number":["AGL 2010-229-C03-03"]}]},{"name":"Generalitat Valenciana, Spain","award":["PI0105\/2007"],"award-info":[{"award-number":["PI0105\/2007"]}]},{"name":"Generalitat Valenciana, Spain","award":["PROMETEO 17\/20217"],"award-info":[{"award-number":["PROMETEO 17\/20217"]}]},{"name":"Generalitat Valenciana, Spain","award":["PROMETEO 21\/2021"],"award-info":[{"award-number":["PROMETEO 21\/2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Peripheral artery disease (PAD) is a major vascular condition often overlooked in prevention strategies. We aimed to evaluate the association between cardiovascular health, measured by Life\u2019s Simple 7 (LS7), and the risk of PAD in a high-risk Mediterranean population. Methods: This prospective analysis included 7122 participants from the PREDIMED study (Prevenci\u00f3n con Dieta Mediterr\u00e1nea) at high cardiovascular risk but free of cardiovascular disease at baseline. LS7 scores (0\u201314 points) were calculated using seven metrics: smoking status, body mass index, physical activity, blood pressure, total cholesterol, glucose metabolism, and adherence to the Mediterranean diet. Participants were categorized into inadequate (0\u20135), average (6\u20138), and optimal (9\u201314) cardiovascular health. Multivariable Cox regression models and Nelson\u2013Aalen curves assessed the association between LS7 and PAD incidence over a median 4.8-year follow-up. A meta-analysis combining these results with three prior studies was also performed. Results: A total of 87 incident PAD cases were identified. Compared to participants with inadequate cardiovascular health, those with average and optimal LS7 scores exhibited significantly lower PAD risk (adjusted hazard ratio [HR] 0.37; 95% confidence interval [CI]: 0.22\u20130.61, and HR 0.25; 95% CI: 0.10\u20130.65, respectively). Each one-point increase in the LS7 score (range 0 to 14) was associated with an 22% lower PAD risk (HR 0.78; 95% CI: 0.68\u20130.90). The meta-analysis yielded a pooled HR of 0.81 (95% CI: 0.76\u20130.87), confirming consistent inverse associations across populations. Conclusions: Greater adherence to LS7 metrics is associated with a significantly reduced risk of PAD in high-risk Mediterranean individuals. Promoting LS7 adherence may represent an effective strategy for preventing both cardiovascular disease and PAD.<\/jats:p>","DOI":"10.3390\/nu17132058","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T11:23:24Z","timestamp":1750418604000},"page":"2058","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Life\u2019s Simple 7 and Risk of Peripheral Artery Disease: Results from the PREDIMED Study and an Updated Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2092-0360","authenticated-orcid":false,"given":"Nieves","family":"L\u00f3pez-Laguna","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain"},{"name":"Emergency Department, Cl\u00ednica Universidad de Navarra, 28027 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6263-4434","authenticated-orcid":false,"given":"Estefan\u00eda","family":"Toledo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-8567","authenticated-orcid":false,"given":"Mar\u00eda S.","family":"Hershey","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain"},{"name":"Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Boston, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-5277","authenticated-orcid":false,"given":"Nancy","family":"Babio","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Universitat Rovira i Virgili, Departament de Bioqu\u00edmica i Biotecnologia, Unitat de Nutrici\u00f3 Humana, Grup Almentaci\u00f3, Nutrici\u00f3, Desenvolupament i Salut Mental (ANUT-DSM), 43880 Reus, Spain"},{"name":"Institut D\u2019Investigaci\u00f3 Sanit\u00e0ria Pere Virgili (IISPV), 43880 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0130-2006","authenticated-orcid":false,"given":"Jos\u00e9 V.","family":"Sorl\u00ed","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Ros","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e9diques August Pi Sunyer (IDIBAPS), Hospital Cl\u00ednic, 08002 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4083-3248","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Atenci\u00f3n Primaria Idiap Jordi Gol, 08002 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram\u00f3n","family":"Estruch","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Department of Internal Medicine, Institut d\u2019Investigacions Biom\u00e9diques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08002 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3873-5737","authenticated-orcid":false,"given":"Jos\u00e9","family":"Lapetra","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Department of Family Medicine, Research Unit, Distrito Sanitario Atenci\u00f3n Primaria Sevilla, 41001 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9949-8691","authenticated-orcid":false,"given":"Carlos","family":"Mu\u00f1oz-Bravo","sequence":"additional","affiliation":[{"name":"Department of Public Health and Psychiatry, University of Malaga, 29015 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), 29015 Malaga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miquel","family":"Fiol","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07240 Illes Balears, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9257-8739","authenticated-orcid":false,"given":"Inmaculada","family":"Bautista-Casta\u00f1o","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-2444","authenticated-orcid":false,"given":"Xavier","family":"Pinto","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, Universidad de Barcelona, 08097 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6719-9358","authenticated-orcid":false,"given":"Carolina","family":"Ortega-Azor\u00edn","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6777-1649","authenticated-orcid":false,"given":"Javier","family":"Hernando-Redondo","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Registre Giron\u00ed del Cor (REGICOR) Study Group, Hospital del Mar Research Institute (IMIM), 08097 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2700-7459","authenticated-orcid":false,"given":"Jordi","family":"Salas-Salvad\u00f3","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Universitat Rovira i Virgili, Departament de Bioqu\u00edmica i Biotecnologia, Unitat de Nutrici\u00f3 Humana, Grup Almentaci\u00f3, Nutrici\u00f3, Desenvolupament i Salut Mental (ANUT-DSM), 43880 Reus, Spain"},{"name":"Institut D\u2019Investigaci\u00f3 Sanit\u00e0ria Pere Virgili (IISPV), 43880 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5338-9601","authenticated-orcid":false,"given":"Lucas","family":"Tojal-Sierra","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV\/EHU, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-9808","authenticated-orcid":false,"given":"Miguel A.","family":"Mart\u00ednez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7684-2787","authenticated-orcid":false,"given":"Miguel","family":"Ruiz-Canela","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","unstructured":"GBD 2019 Peripheral Artery Disease Collaborators (2023). 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Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1253\/circj.CJ-14-0062","article-title":"Lifestyle and dietary risk factors for peripheral artery disease","volume":"78","year":"2014","journal-title":"Circ. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1177\/2047487312452968","article-title":"Peripheral arterial disease, prevalence and cumulative risk factor profile analysis","volume":"21","author":"Eraso","year":"2014","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.atherosclerosis.2018.05.049","article-title":"Risk of peripheral artery disease according to a healthy lifestyle score: The PREDIMED study","volume":"275","author":"Toledo","year":"2018","journal-title":"Atherosclerosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1161\/CIRCULATIONAHA.109.192703","article-title":"Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction the American Heart Association\u2019s Strategic Impact Goal Through 2020","volume":"121","author":"Hong","year":"2010","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1093\/eurjpc\/zwad405","article-title":"Ideal cardiovascular health and cardiovascular-related events: A systematic review and meta-analysis","volume":"31","author":"Spronk","year":"2024","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.recesp.2019.05.010","article-title":"Impact of Life\u2019s Simple 7 on the incidence of major cardiovascular events in high-risk Spanish adults in the PREDIMED study cohort","volume":"73","author":"Babio","year":"2020","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/ije\/dyq250","article-title":"Cohort profile: Design and methods of the PREDIMED study","volume":"41","author":"Corella","year":"2012","journal-title":"Int. J. Epidemiol."},{"key":"ref_12","first-page":"1279","article-title":"Primary prevention of cardiovascular disease with a Mediterranean diet","volume":"34","author":"Estruch","year":"2018","journal-title":"N. Engl. J. 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