Final Report Summary - PSYCHO CARDIO SPAIN (Psychosocial Factors and Cardiovascular Disease in Spain) Cardiovascular diseases (CVD) are the principal cause of death and morbidity worldwide, being responsible for 1.9 million deaths each year in the European Union alone. The appearance of the disease and its progression are determined by the presence of several well-established risk factors, including smoking, dyslipidemia, hypertension, obesity and diabetes. Several novel risk factors have been associated with CVD mortality, including those related to psychosocial factors (depression, stress, etc.) and social determinants as urban environments and social differences. The main objective of the PIRG 249302 - PSYCHO CARDIO SPAIN is to study the social determinants of cardiovascular health. These upstream determinants shape our cardiovascular behaviors (smoking, diet, physical activity, etc…) and psychosocial factors as stress, job strain, anxiety, sleep disorders, depression and social support. The PIRG has been of great help for me during these important 4 years in my research career. PIRG has been fundamental for me to get established at the University of Alcalá with a tenure position and as the coordinator of a productive and international research group. The work at the research group finally helped me preparing a competitive grant submission for the ERC Starting Grant 2013, which I was awarded. Within the PESA study (www.estudiopesa.org) we have evaluated the influence of psychosocial factors on the prevalence and progression of subclinical atherosclerosis. In this longitudinal study, which is being carried out in Madrid since 2010 on middle-age male and female employees with a 6 years follow-up.More than 4000 participants have completed the Sleep Habits Questionnaire and other questionnaires to assess the depression scale (Center for Epidemiologic Studies Depression), social support, and stress at home and at work. Participants also carried accelerometers, providing the necessary data to assess any sleep disorder (insomnia, sleep, apnea). These questionnaires have been previously used in the Multi-Ethnic Study of Atherosclerosis (MESA) study where I conducted my PhD in Johns Hopkins, aiming to compare our findings. Although the recruiting process has been complex, by February (2014) there were already 4184 participants enrolled. The first article of the study (on the study rationale and study design) has been already published. However, clean data on results are not complete and available for our objectives yet. In addition to continuing with the PESA study and following the same research line “Social and Cardiovascular Epidemiology” that I have pursued since 2002 when I started at Johns Hopkins School of Public Health, I founded in 2013 the “Social and Cardiovascular Epidemiology Research Group” at the University of Alcalá. This team effort helped fostering epidemiological research on social determinants on cardiovascular health www3.uah.es/cardiosocialepi a discipline that did not exist in Spain previously. Within this group we have been working on different research areas such as tobacco prevention, gender differences in cardiovascular risk, natural experiments and cardiovascular health, or population preventive approaches for cardiovascular diseases. In a short period of time we have produced several high impact publications and I have been awarded an ERC-Starting Grant 2013 to develop the specific research line of urban environment and cardiovascular health. http://hhhproject.eu/ I am currently preparing an Innovative Training Network (ITN) Call: H2020-MSCA-ITN-2015 in collaboration with top cardiovascular epidemiologists. Again, my previous experience with the PIRG has been of great help. At the University of Alcalá, with the priceless help of the PIRG, I expect to build a multidisciplinary and international team of researchers devoted to epidemiology and public health. The ERC project may have impact for cardiovascular disease population preventive strategies, allowing us to better prevent and control cardiovascular disease.