Abstract 4370685: Association Between Food Insecurity and Cardiovascular Risk Factors: A Cross-Sectional Analysis of NHANES Data

Background: Food insecurity is a growing social determinant of health in the United States, with potential implications for cardiovascular disease. However, its relationship with key cardiovascular risk factors such as hypertension and hypercholesterolemia remains incompletely defined. Objective: To examine the independent association between food insecurity and two major cardiovascular risk factors: hypertension and high cholesterol, using a nationally representative dataset. Methods: We conducted unweighted logistic regression analyses using National Health and Nutrition Examination Survey (NHANES) data. Adults with complete data on food security, hypertension, and cholesterol status were included (n = 5,949; 484 excluded for missing data). Food insecurity was defined per USDA guidelines. Primary outcomes were self-reported physician diagnosis of hypertension and high cholesterol. Multivariable logistic regression models were fitted, adjusting for age, sex, BMI, income, smoking status, and physical activity. Subgroup analyses were performed by sex and income strata. Results: In unadjusted models, food insecurity was significantly associated with higher odds of hypertension (OR 1.23; 95% CI: 1.08–1.41; p = 0.0012), but not with high cholesterol (OR 1.00; p = 0.998). After multivariable adjustment, food insecurity remained an independent predictor of hypertension ( p < 0.01), but showed no significant association with high cholesterol. Subgroup analysis revealed the association between food insecurity and hypertension was stronger in females and low-income individuals, while no subgroup showed a significant association with high cholesterol. Conclusions: Food insecurity is independently associated with increased odds of hypertension, but not high cholesterol, in the U.S. adult population. These findings support the need for integrating food security screening into cardiovascular risk assessments, especially among vulnerable populations.