Cross-sectional and prospective data on Framingham risk score, allostatic load, and ankle brachial index among Puerto Rican adults from the Boston Puerto Rican Health Study

Background
Puerto Ricans have higher odds of peripheral artery disease (PAD) compared with Mexican Americans. Limited studies have examined relationships between clinical risk assessment scores with PAD assessments.

Methods
Using 2004-2015 data from the Boston Puerto Rican Health Study (BPRHS) (n = 370-583), cross-sectional, 5-y change and patterns of change in Framingham Risk Score (FRS) and allostatic load (AL) with ankle brachial index (ABI) at 5-y follow-up was assessed among Puerto Rican adults (45-75 y). Analysis were conducted in 2020. FRS and AL were calculated at baseline, 2-y and 5-y follow-up. Multivariable linear regression models examined cross-sectional and 5-y changes in FRS and AL with ABI at 5-y. Latent growth mixture modeling identified trajectories of FRS and AL over 5-y, and multivariable linear regression models were used to test associations between trajectory groups at 5-y.

Results
Greater FRS at 5-y and increases in FRS from baseline were associated with lower ABI at 5-y (β = -0.149, p = 0.010; β = -0.171, p = 0.038, respectively). AL was not associated with ABI in cross-sectional or change analyses. Participants in low-ascending (vs. no change) FRS trajectory, and participants in moderate-ascending (vs. low-ascending) AL trajectory, had lower 5-y ABI (β = -0.025, p = 0.044; β = -0.016, p = 0.023, respectively).

Conclusions
FRS was a better overall predictor of ABI, compared with AL. FRS may be a clinically feasible measure of PAD risk in Puerto Ricans, an understudied population. Additional research examining relationships between FRS and AL and development of PAD is warranted.