Abstract 4370893: Joint Associations Between Social and Psychological Health Risk and Life’s Essential 8 Among Women of Reproductive Age: Insights from the SAFE HEART Study

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of morbidity among women of reproductive age. Social and psychological adversities may worsen cardiovascular health, but their joint effects on Life’s Essential 8 (LE8) risk factors are understudied. Methods: We conducted a cross-sectional analysis of women aged 18–50 years recruited from community outreach and the American Heart Association’s Research Goes Red registry. A three-level risk variable (low, moderate, high) was created using a standardized polysocial risk score and psychological health indicators. The polysocial score reflected disadvantage across socioeconomic (education, employment, income, insurance, financial strain), living (housing, marital status, home ownership), food, transportation, utilities, and safety domains. Psychological health was assessed using validated measures of stress, depression, and anxiety. Women were classified as low-risk (lowest tertile, 0–1 psychological risks), moderate-risk (middle tertile and/or 2 risks), or high-risk (highest tertile and/or all 3 risks). Self-reported LE8 risk factors included hypertension, diabetes, high cholesterol, BMI, physical activity, sleep, smoking, and diet. Multivariable logistic regressions estimated adjusted odds ratios (aORs), adjusting for age, race/ethnicity, and LE8 metrics. Results: Among 430 women (mean age 30.0 ± 6.8 years), 12.1% were low-risk, 36.5% moderate-risk, and 51.4% high-risk. Compared to the low-risk group, high-risk women had greater odds of hypertension (aOR = 4.50; 95% CI: 2.06–9.81), poor sleep (aOR = 1.96; 95% CI: 1.02–3.76), and low fruit/vegetable intake (aOR = 2.19; 95% CI: 1.10–4.36). Moderate-risk women also had elevated odds of low fruit/vegetable intake (aOR = 2.08; 95% CI: 1.02–4.21). BMI, cholesterol, and diabetes varied across groups. Smoking odds were higher in moderate-risk (aOR = 1.64; 95% CI: 0.67–4.01) and high-risk (aOR = 1.71; 95% CI: 0.71–4.15) groups. High-risk women were less likely to report low physical activity (aOR = 0.54; 95% CI: 0.25–1.16). Conclusion: A high burden of co-occurring social and psychological health risks were associated with adverse LE8 profiles among women of reproductive age. These findings underscore the need for coordinated screening and prevention strategies that address both social and psychological risk factors to mitigate immediate risks for adverse pregnancy and maternal health outcomes and reduce long-term cardiovascular disease risk across the life course.