Abstract Body: Background:
Hypertension is a leading contributor to cardiovascular disease among women of reproductive age. Upstream social determinants of health may impact hypertension. Food insecurity, defined as limited or uncertain access to adequate food, may increase the risk of hypertension. Despite this, the relationship between food insecurity and hypertension remains understudied in this population.
Methods:
We analyzed cross-sectional data from 430 women aged 18–50 participating in the SAFE HEART Study in Baltimore and Washington, D.C. Food insecurity was assessed using two validated questions reflecting concerns about food running out and food not lasting. Logistic regression models estimated odds ratios (ORs) for hypertension associated with each item across three models: (1) unadjusted, (2) adjusted for sociodemographic factors (age, race/ethnicity, education, employment, insurance, income, marital status), and (3) fully adjusted for cardiovascular risk factors (physical activity, diet, sleep, and BMI).
Results:
Among the 430 participants, the mean age was 30.7 ± 6.8 years; 44.7% identified as Non-Hispanic Black, 28.1% as Hispanic/Other, and 23.0% as Non-Hispanic White. Food insecurity was significantly associated with higher odds of hypertension in crude and adjusted models. Women who worried about food running out had 3.27 times the odds of hypertension (95% CI: 2.14–5.00), which remained significant after sociodemographic adjustment (OR = 2.12; 95% CI: 1.30–3.45), and in fully adjusted models (OR = 2.14; 95% CI: 0.1.30–3.52). Similarly, women who reported food not lasting had higher odds of hypertension (crude OR = 3.06; 95% CI: 2.01–4.66; adjusted OR = 1.93; 95% CI: 1.19–3.12), which remained significant in the fully adjusted model (OR = 1.98; 95% CI: 1.21–3.24).
Conclusion:
Food insecurity was associated with significantly higher odds of hypertension among women of reproductive age, independent of sociodemographic and cardiovascular risk factors. These findings underscore food insecurity as a potential modifiable upstream driver of hypertension risk in this population.