Abstract Body: Introduction: Cardiovascular health literacy (CVHL) is vital for managing cardiovascular risk. However, poor mental health can be a barrier, and there's a gap in understanding how mental health impacts CVHL in women.

Hypothesis: We hypothesized that mental health has an association with cardiovascular health literacy. We further hypothesized that this would vary by younger age.

Methods: We conducted a cross-sectional study using data from the Research Goes Red registry and SAFE HEART study. Women aged ≥18 completed questionnaires on cardiovascular health literacy (CVHL) and mental health. CVHL was assessed using a validated tool, with scores ranging 0-100. It included knowledge of CVD risk factors, exercise, diet, and therapeutic interventions. Psychological health risk was measured using the Perceived Stress Scale (PSS-4; score 1-16), Generalized Anxiety Disorder scale (GAD-2; score 1-6), and Patient Health Questionnaire (PHQ-2; score 0-6) for assessing depression. Stepwise linear regression models evaluated associations between mental health and CVHL. Final adjusted models employed spline terms for PHQ-2 (scores 1, 2, 3), GAD-2 (scores 1, 2, 3), and PSS-4 (scores 4, 8, 12).

Results: A total of 677 women were included in the analysis. Mean age 40.07 (SD15.30), 29.08% Black, and 64.1% employed. Our analysis revealed complex associations between mental health measures and cardiovascular health literacy (CVHL). Perceived stress (PSS-4) showed a non-linear relationship with CVHL (β=-2.64, 7.28, -5.72 for scores 4, 8, ≥12 respectively; all p<0.05). Depression (PHQ-2) demonstrated a significant negative association at score 1 in the crude model (β=-6.51, 95% CI: -10.69, -2.34), which attenuated after adjustment. Anxiety (GAD-2) showed a significant positive association at scores ≥3 in the crude model (β=6.94, 95% CI: 2.06, 11.83), also attenuating after adjustment. Age ≥50 was consistently associated with higher CVHL scores across all models (β range: 10.49-13.3; all p<0.001). Physical activity <150 minutes/week showed a positive association (β=4.76, p<0.05), but interacted negatively with BMI ≥25 (β=-7.12, p<0.05). Financial strain was negatively associated with CVHL (β=-6.41, 95% CI: -9.16 to -3.67, p<0.001).

conclusion: Mental health and CVHL show complex relationships, older age consistently predicting higher CVHL. Financial strain negatively impacts CVHL, highlighting the need for targeted interventions addressing both psychological and socioeconomic factors.