Abstract Body: Background
Hypertension in reproductive-aged women is often underrecognized and undertreated. Understanding how healthcare access influences cascade performance (awareness, treatment, and control) can inform early interventions in this population.

Methods
We conducted a cross-sectional descriptive analysis of women with hypertension (N=73) amongst 231 enrolled in the SAFEHeart study. Hypertension was defined as self-reported diagnosis, or average systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥80 mmHg, based on the average of the 2nd and 3rd readings. Among hypertensive participants, we assessed awareness, treatment, and control (average SBP <130 and DBP <80 mmHg). Insurance status, primary care provider (PCP) presence, and transportation barriers were examined at each stage.

Results
The mean age was 35.0 years (95% CI: 32.9–37.0). Of the 73 participants with hypertension, 46 (63.0%) were aware of their diagnosis. Of those aware, 10 (21.7%) were on treatment, and among those treated, 5 (50.0%) had controlled blood pressure. Among the 46 aware individuals, 63.0% were insured, 47.8% had a PCP, and 17.4% reported transportation barriers. Among the 27 not aware, 59.3% were insured, 51.9% had a PCP, and 14.8% had transportation barriers. Among the 10 treated individuals, 100.0% were insured, 60.0% had a PCP, and 20.0% had transportation barriers. Among the 63 not treated, 55.6% were insured, 47.6% had a PCP, and 15.9% had transportation barriers. Among the 5 with controlled blood pressure, 100.0% were insured, 40.0% had a PCP, and 20.0% reported transportation barriers. Among the 68 not controlled, 58.8% were insured, 50.0% had a PCP, and 16.2% reported transportation barriers.

Conclusion
While a majority of hypertensive women were aware of their diagnosis, treatment and control rates remained low. Insurance coverage was highest among those treated and controlled. However, gaps in primary care access and transportation barriers were observed at each stage. These findings underscore the need for tailored strategies to address logistical barriers and enhance continuity of care in this population.