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.