Abstract Body (Do not enter title and authors here): Introduction:
Hypertension (HTN) prevalence is worsening among women of reproductive age (18-44 years), leading to higher maternal morbidity and mortality rates. We sought to evaluate social risks and cardiovascular health (CVH) among women aged 18-44 years, in a national registry.

Methods:
We conducted a cross-sectional analysis of participants enrolled in the American Heart Association Research Goes Red Registry, who responded to questionnaires on heart health and social risks. Adverse social risks were measured using a polysocial risk score ranging from 0 to 16, with higher scores indicating greater social disadvantage. The polysocial risk score included variables from several domains: sociodemographic information, living situation, food security, transportation, utilities, safety, and financial strain. CVH was assessed by the number of CVH risk factors based on Life’s Essential 8: diet, physical activity, smoking, blood pressure, blood sugar, body mass index, and cholesterol, where a lower number of risk factors indicates more optimal CVH. Linear regression models were used to assess the association between polysocial risk score and CVH.

Results: Among the 637 women (mean age range 18-29 years, 30% Non-Hispanic Black), 64% had polysocial risk scores less than 7, while 36% had scores greater than 7. Most participants were married or cohabitating (66%) and had some college education or higher (87%). Financial strain was reported by 51%, with 47% earning less than $50,000 annually. In terms of cardiovascular health, 33% had diabetes, 46% had high cholesterol, 44% had high blood pressure, and 69% had a high body mass index. High polysocial scores (scores > 7) were significantly associated with increased cardiovascular health risk factors (coefficient = 0.4733, p < 0.001), while lower polysocial scores (scores < 7) were not significantly associated with cardiovascular health risk (coefficient = 0.0357, p = 0.229). Additionally, Spearman’s rank correlation showed a moderate positive relationship (Spearman's rho = 0.2395, p = 0.0000), indicating that as polysocial scores increase, the number of CVH risk factors also increases (Figure).

Discussion: Women of reproductive age with high number of social risks are at a significantly increased risk of suboptimal cardiovascular health. Screening for social needs and developing public health interventions tailored for women with high social burdens must be prioritized to improve cardiovascular health.