Allostatic load is associated with chronic conditions in Puerto Rican older adults

Puerto Ricans in the United States present multiple disparities for disease. Allostatic load (AL), or physiological dysregulation in response to stressors, has been proposed as a mechanism for health disparities, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to chronic disease in Puerto Ricans, and to assess potential mechanisms for its primary and secondary mediators. Data was obtained from questionnaires and biological samples collected from participants of the Boston Puerto Rican Health Study (n=1116, ages 45-75 years). A definition for AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Parameters were further categorized by primary or secondary mediators. Logistic regression models were run to determine association of AL and disease status, controlling for age, sex, smoking, alcohol use, physical activity, perceived stress, total fat intake and energy intake. Increasing categories of AL score were significantly associated with abdominal obesity, hypertension, diabetes and self-reported cardiovascular disease (CVD) and arthritis, but not with self-reported cancer. Primary mediators of AL were not associated with any condition, while secondary mediators were associated with all conditions except cancer. The strength of associations of AL with diabetes, CVD and arthritis paralleled those of the secondary mediators, but were weaker for abdominal obesity and hypertension. In conclusion, Puerto Ricans experienced physiological dysregulation that was associated with increased odds of chronic conditions. These results have prospective implications for interventions and research in Puerto Ricans and other ethnic groups.