Knowledge of cardiovascular diseases among patients with diabetes mellitus in the Kingdom of Saudi Arabia: A cross-sectional study

Diabetes mellitus (DM) is known to be associated with cardiovascular disease. This study aims to determine the level of knowledge about cardiovascular diseases among DM patients in the Kingdom of Saudi Arabia. This online cross-sectional survey study was conducted between March 2024 and April 2025 in Saudi Arabia. The study population comprised patients diagnosed with DM and aged at least 18 years who were currently residents in Saudi Arabia. The questionnaire for this study was adopted from a previous study by Wagner et al, named the Heart Disease Fact Questionnaire. Logistic regression analysis was conducted to predict significant factors influencing the knowledge of heart disease. Most participants had good knowledge of heart disease risk factors. For example, 210 (94.2%) knew that smoking is a risk factor, and 202 (94.2%) agreed that quitting smoking reduces the risk. In addition, 199 (91.7%) recognized high blood pressure as a risk factor, and 204 (93.4%) knew that controlling it reduces heart disease risk. A total of 200 (94.8%) understood that high blood sugar over time increases cholesterol and heart disease risk, and 194 (92.4%) believed that good blood sugar control helps reduce this risk. Furthermore, some misconceptions were observed: 185 (78.4%) incorrectly believed a person always knows when they have heart disease, and 118 (57.3%) thought people with diabetes rarely have high cholesterol. Smokers had significantly lower odds of good knowledge compared with nonsmokers (odds ratio = 0.32, 95% confidence interval: 0.11-0.90, P = .031). Conversely, participants who adhered to their treatment were significantly more likely to have good knowledge (odds ratio = 4.63, 95% confidence interval: 1.09-19.67, P = .038). The majority of the participants had a high level of understanding of the risk factors for heart disease. There were significant misconceptions regarding diabetes-related cholesterol risk and the symptoms of heart disease. Compliant patients had a higher level of awareness, and smokers had a significantly lower level of knowledge. These findings point to the necessity for educational interventions that are specifically designed to address particular deficiencies.