Abstract Body: Background: Civic engagement including voting, volunteering, and participating in public meetings is essential for shaping community priorities and health policy. Individuals with cardiovascular diseases (CVD) may experience physical and psychosocial limitations that reduce their civic participation. However, nationally representative evidence on this topic remains limited.

Hypothesis: Cardiovascular disease was hypothesized to be associated with lower rates of civic activity compared to those without cardiovascular disease, after adjusting for sociodemographic and health-related factors.

Methods: We used data from 27,631 adults in the 2022 National Health Interview Survey, a cross-sectional survey of the non-institutionalized US population. Cardiovascular disease was defined as self-reported coronary heart disease, angina, heart attack, or stroke. Civic engagement outcomes included voting in local elections, attending public meetings, and volunteering. Multivariable logistic regression models were used to assess the association between cardiovascular disease and civic engagement, adjusting for age, sex, race, ethnicity, education, income, region, and other chronic conditions. Sampling weights were applied to produce nationally representative estimates.

Results: Cardiovascular disease was reported by 2,916 individuals (10.6%). After applying survey weights, respondents with CVD were more likely to be older, male, and have lower educational attainment and household income compared to those without CVD. In adjusted models, individuals with CVD had significantly lower odds of civic engagement: voting (adjusted odds ratio [aOR]: 0.82, 95% CI: 0.70–0.96), attending public meetings (aOR: 0.78, 95% CI: 0.61–0.99), and volunteering (aOR: 0.73, 95% CI: 0.61–0.88). Among subtypes, coronary heart disease (aOR: 0.74, 95% CI: 0.58–0.94) and heart attack (aOR: 0.71, 95% CI: 0.54–0.94) were associated with lower volunteering. Stroke was associated with lower voting (aOR: 0.73, 95% CI: 0.56–0.93).

Conclusions: Cardiovascular disease is associated with reduced civic engagement across multiple domains. Barriers may include physical limitations and competing care needs. Strategies such as virtual participation and accessible civic programming may help promote inclusion and support patient-centered advocacy.