Factors associated with higher cardiovascular disease risk awareness among patients with cardiovascular risk factors in primary care

Cardiovascular diseases (CVD) remain a leading cause of morbidity and mortality due to the increasing prevalence of major CVD risk factors, including type 2 diabetes mellitus, hypertension, dyslipidaemia and obesity. Lifestyle intervention is crucial for tackling these risk factors and curbing CVD. A prerequisite for adopting healthy behaviour is an individual’s awareness of their CVD risk. Therefore, this study aimed to determine the overall CVD risk awareness and identify factors associated with higher CVD risk awareness among individuals with CVD risk factors in primary care. A cross-sectional study was conducted among individuals with at least one CVD risk factor at a university primary care clinic from June 2024 until February 2025. CVD risk awareness was measured using the Attitudes and Beliefs of Cardiovascular Disease $$\:-$$ Malay version (ABCD-M) questionnaire. Multiple linear regression was utilised to identify the factors associated with higher CVD risk awareness. A total of 394 patients were recruited. The mean age was 53.3 (± 8.9). The majority were Malays (59.6%), married (60.2%), and females (55.3%). The mean ABCD-M risk score was 60.1 (± 8.98), indicating high overall CVD risk awareness. Significant factors associated with higher CVD risk awareness included secondary education (B = 5.54, 95% CI: 4.75, 6.34, < 0.001), tertiary education (B = 13.3, 95% CI: 12.1, 14.4, p < 0.001), Middle 40% (M40) household income category (B = 2.57, 95% CI: 1.90, 3.25 p < 0.001), Top 20% (T20) household income category (B = 3.02, 95% CI: 2.12, 3.92, p < 0.001), personal history of CVD (B = 4.06, 95% CI: 3.17, 4.95, p < 0.001), first-degree family history of CVD (B = 2.52, 95% CI: 1.65, 3.39, p < 0.001), and high Framingham Risk Scores (FRS) (B = 2.04, 95% CI: 1.17, 2.91, p < 0.001). This study revealed a high mean score for overall CVD risk awareness among patients with CVD risk factors in our primary care clinic. Higher education levels, higher income categories, personal and family history of CVD and high FRS were significantly associated with higher CVD risk awareness. These findings could be used to develop targeted interventions to improve CVD risk awareness and promote healthy behaviours in primary care.