Cardiovascular Disease Risk Knowledge and Lifestyle Behaviors Among Adults With Metabolic Syndrome: A Cross Sectional Study

Abstract: Background: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, largely driven by modifiable cardiometabolic risk factors. Adults with metabolic syndrome (MetS) represent a particularly high cardiometabolic risk group in whom preventive strategies are crucial; however, their level of knowledge regarding CVD, its risk factors, and related lifestyle behaviours remains insufficiently characterized. This study aimed to assess the knowledge of CVD and its risk factors among adults with MetS and to examine their associations with lifestyle behaviors and metabolic control. Methods: In this single-center cross-sectional study, 350 adults with MetS diagnosed according to ATP III criteria were evaluated. Cardiovascular knowledge was assessed using the validated Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. Lifestyle behaviors, anthropometric measurements, laboratory parameters, and medication use were recorded. Associations between CARRF-KL scores and patient characteristics, lifestyle behaviours, and metabolic control were examined. Results: The mean age of the study population was 45.7 ± 11.5 years, and 72% were female. The mean total CARRF-KL score was 21 ± 3, with 42% of participants demonstrating high knowledge levels (≥80% correct responses). Despite this, adherence to lifestyle recommendations was suboptimal, with only 6% reporting regular physical activity and 26% adhering to dietary recommendations. Notably, only 9% of participants were aware of their MetS diagnosis. Higher knowledge scores were associated with higher educational level, better dietary adherence, and lipid-lowering therapy use (p < 0.05), as well as lower rates of smoking and alcohol consumption. However, no significant associations were observed with physical activity or weight-related measures. Conclusion: Although adults with MetS demonstrated moderate to high awareness of CVD and its risk factors, this knowledge did not consistently translate into healthier lifestyle behaviors. Prevention strategies targeting high cardiometabolic-risk populations should extend beyond information dissemination and incorporate behavioral and motivational components to improve cardiovascular outcomes.