Patterns of cardiovascular disease subtypes and associated factors among young adults in Peshawar, Pakistan: a multicenter hospital-based cross-sectional study

Background Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality. Evidence on CVD subtypes in young Pakistani adults is limited. This study characterized CVD subtypes and associated factors among young adults in Peshawar Khyber Pakhtunkhwa, Pakistan.Methods A multicentre, cross-sectional study was conducted at four hospitals among patients aged 18–45 years. Data were extracted from three-year hospital records. Associations were assessed using chi-square/Fisher’s exact tests and logistic regression.Results 8,650 CVD cases, 2,090 (24.2%) were young adults, predominantly male (64.6%), with a median age of 40 years (IQR: 36–44). ACS was the most common subtype (61.0%), followed by cardiomyopathy (39.0%). Overweight/obesity (77.0%), hypertension (56.5%), smoking (39.7%), dyslipidaemia (21.8%), and diabetes (14.4%) were the most prevalent factors. Compared with ACS, cardiomyopathy was independently associated with high heart rate, hypertension, dyslipidaemia, diabetes, and family history. Smoking was associated with lower odds of cardiomyopathy than ACS (aOR: 0.50, 95% CI: 0.41–0.61, p < 0.001).Conclusions Young adults accounted for 24.2% of CVD cases, with ACS and cardiomyopathy the most common subtypes, highlighting the need for targeted strategies. The cross-sectional design, findings indicate subtype differences rather than causal effects, while supporting smoking cessation and early hypertension detection in young adults.