Association between polysocial risk score and CVH among women of reproductive age in the SAFE HEART study: An American Heart Association Research Goes Red Initiative

BACKGROUND: To assess the association between polysocial risk factors and cardiovascular health (CVH) among women of reproductive age. METHODS: Our cross-sectional analysis included women of reproductive age (18-44 years) from community settings and the American Heart Association's Research Goes Red (RGR) registry. Polysocial risk scores (0-14) reflected social disadvantage across domains including socioeconomic stability (education, employment, income, insurance, financial strain), living situation (housing stability, housing quality, marital status, home ownership), food security, transportation, utilities, and interpersonal safety. Suboptimal CVH was defined as having ≥2 risk factors from Life's Essential 8 metrics: physical activity, diet, body mass index, sleep, smoking, blood pressure, blood sugar, and cholesterol. Associations between polysocial risk and suboptimal CVH were analyzed using linear regression models RESULTS: Suboptimal CVH increased with higher polysocial risk, from 77.0 % in the lowest quartile to 95.2 % in the highest. Participants in quartile 3 had the highest odds of suboptimal CVH (aOR 9.52, 95 % CI 2.63-34.46), while quartile 4 showed decreased but significant odds (aOR 3.86, 95 % CI 1.03-14.40) compared to quartile 1. Hypertension (aOR 10.23, 95 % CI 3.61-29.01), diabetes (aOR 8.87, 95 % CI 3.12-25.24), hyperlipidemia (aOR 7.48, 95 % CI 2.72-20.55), and smoking (aOR 9.46, 95 % CI 3.25-27.56) were strongly associated with higher polysocial risk in community-enrolled participants, whereas trends were less consistent in RGR-enrolled participants. CONCLUSIONS: Women with higher social risks face greater odds of suboptimal CVH. Screening for social determinants and tailored public health interventions are essential for mitigating CVH risks in this population.