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Cardiovascular disease affects 37% of Hispanic women and is the leading cause of death among Hispanic women in the United States. Hispanic women have a higher burden of cardiovascular risk factors, are disproportionally affected by social determinants of health, and face additional barriers related to immigration, such as discrimination, language proficiency, and acculturation. Despite this, Hispanic women show lower rates of cardiovascular disease and mortality compared with non-Hispanic White women. However, this "Hispanic paradox" is challenged by recent studies that account for the diversity in culture, race, genetic background, country of origin, and social determinants of health within Hispanic subpopulations. This review provides a comprehensive overview of the cardiovascular risk factors in Hispanic women, emphasizing the role of social determinants, and proposes a multipronged approach for equitable care. [Display omitted] • Hispanic women face disproportionate cardiovascular risk, although there is considerable heterogeneity among subpopulations. • Social determinants of health influence cardiovascular risk in Hispanic women. • A multipronged approach is needed to address social determinants of health and achieve equitable care for Hispanic women. [ABSTRACT FROM AUTHOR]