Cardiovascular Disease Literacy and Risk Factor Awareness in a Metropolitan South Asian Population: Findings from a Cross-Sectional Study in Karachi

Background: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, disproportionately affecting low- and middle-income countries. In Pakistan, rapid urbanization and lifestyle transitions have contributed to rising CVD prevalence, yet public awareness of risk factors and symptoms remains poorly characterized. Objective: This study aimed to assess levels of CVD literacy, identify gaps in risk factor and symptom awareness, and examine sociodemographic predictors of knowledge among adults in Karachi, Pakistan. Methods: A cross-sectional survey was conducted between August and November 2024 among 377 Karachi residents aged 20–80 years, excluding healthcare professionals. A structured, pilot-tested questionnaire captured demographic variables, lifestyle factors, and CVD knowledge domains. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported, with significance set at p < 0.05. Results: Smoking (73.5%) and stress (72.7%) were the most frequently recognized risk factors, whereas awareness of physical inactivity (42.7%), diabetes (39.8%), and family history (43.0%) was limited. Chest pain was the best-known symptom (78.8%), but stroke warning signs were identified by only 39.0%. Higher knowledge was significantly associated with female gender (OR 1.58, CI 1.07–2.31), younger age groups, upper socioeconomic class (OR 1.88, CI 1.12–3.16), healthy diet (OR 1.99, CI 1.38–2.88), and family history of CVD (OR 1.54, CI 1.11–2.12). Conclusion: CVD knowledge in Karachi is moderate, with marked gaps in awareness of metabolic risk factors and stroke symptoms. Targeted community-based interventions addressing demographic and socioeconomic disparities are urgently needed to strengthen preventive behaviors.