Abstract 4361432: Cardiovascular Health and Unrecognized Cardiovascular Risk among People Released from Prison: Baseline Findings from the SCHARP Prospective Cohort Study

Background : Compared to the general population, people released from prison suffer two times higher cardiovascular (CV) mortality and have an increased risk of CV events after release. Understanding CV risk among individuals recently released from prison is key to addressing the needs of this population. Methods : The SCHARP (Structural Conditions and Health After Release from Prison) study includes a prospective cohort study measuring CV health scores (at baseline visit) and longitudinal CV outcomes of people recently released from prison in Denver and Aurora, Colorado. Baseline CV data from participants enrolled from August 2023 - April 2025 is presented. CV health was assessed using the American Heart Association’s Life’s Essential 8 (LE8) measures of diet, physical activity, nicotine use, sleep, BMI, blood glucose, blood lipids, and blood pressure (BP). LE8 domain scores were determined using established protocols, then averaged to yield an overall CV health score (Range 0-100). CV health was categorized as poor (0-49), moderate (50-79), or high (80-100). CV health was examined overall, by domain, and by self-reported participant characteristics. Unrecognized CV risk was defined as having an elevated BMI, glucose, lipids, or BP, according to clinical guidelines, and no self-reported prior diagnosis of obesity, diabetes, hyperlipidemia, or hypertension, respectively. Results : Participants’ (n=459) mean age was 42.0 (10.8 sd) years, 86.5% were male, 33.6% were Hispanic ethnicity, and 17.0% were Non-Hispanic Black race. Mean lifetime years of incarceration was 11.9 (9.4 sd). At baseline, participants had an average CV health score of 68.0 (10.9 sd); 5.5% had poor CV health, 79.5% had moderate CV health, and 15.0% had high CV health. Significant differences were observed by age (p=.004), with lower CV health observed among 50-64yo compared to other age groups. Across individual LE8 domains, nicotine use was the lowest scored domain (65.4% current smokers) and physical activity was the highest scored domain (92.2% met activity guidelines). One in four (25.7%) participants had at least one unrecognized CV risk. Obesity (19.6%) and elevated blood pressure (7.4%) were the most common unrecognized risk factors. Conclusions : People recently released from prison had moderate CV health and substantial unrecognized CV risk. Access to high quality healthcare following release from prison is key in the prevention, early detection, and management of CV risk.