Abstract Body: Background
Childhood represents a critical window for the development of cardiovascular health. Early exposure to psychological stress and adverse experiences can alter autonomic, metabolic, and vascular regulation, increasing lifetime cardiovascular disease (CVD) risk. Hispanic children remain understudied despite disproportionate exposure to adversity. Identifying the early indicators of CVD risk factors and psychosocial factors in youth is essential to guide targeted prevention strategies in high-risk populations.

Objective
To characterize the prevalence of pediatric CVD risk factors and psychosocial indicators in Puerto Rican children.

Methods
In this ongoing cross-sectional study, children are recruited from the Puerto Rico Health Justice Center and pediatric community clinics. They complete two visits that include PROMIS Pediatric measures (stress, sleep, family relations), anthropometrics, blood pressure, fasting lipids/glucose, and blood collection for biomarkers. The current analysis includes 38 participants (mean age 12.1 ± 2.3 y; 73% female).

Results
More than half (68.4%) of participants presented one or more CVD risk factors. Prevalence by category was: overweight/obesity = 23.7%, hypertension = 21.6%, high cholesterol = 21.6%, low HDL = 21.6%, and high fasting glucose = 10.8%. Risk-factor clustering (two or more) was observed in 8/38 (21.0%), with 18/38 (47.4%) having one factor, and 12/38 (31.6%) none. Psychosocial indicators revealed that 34.2% reported elevated stress, 23.7% poor sleep, and 47.4% below-average physical activity, reflecting widespread lifestyle and emotional vulnerabilities in this population.

Conclusions
Nearly one in four Hispanic children already exhibits early indicators of multiple cardiovascular risk factors, and more than two-thirds have at least one. These findings underscore the importance of early, culturally sensitive screening and intervention programs in pediatric care and community settings to mitigate long-term cardiovascular risk.