Cardiovascular Risk Awareness Among Adults in the Northern Border Region of Saudi Arabia: A Cross-Sectional Study with Emphasis on Hypertension and Type 2 Diabetes

Background/Objectives: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Individuals with hypertension (HTN) and type 2 diabetes mellitus (T2DM) are at particularly high risk; however, awareness of cardiovascular risk within the broader community and among high-risk subgroups remains suboptimal. This study aimed to assess CVD risk awareness and its correlates among adults in the Northern Border Region of Saudi Arabia, with a particular focus on individuals with HTN and/or T2DM. Methods: A descriptive, quantitative, cross-sectional survey was conducted among adults aged 18–50 years residing in the Northern Border Region of Saudi Arabia. An anonymous online questionnaire was distributed via social media between October 2025 and January 2026. The survey incorporated a 22-item scale assessing HTN knowledge, T2DM knowledge, and CVD risk awareness (Heart Disease Fact items). Participants were categorized according to self-reported diagnosis (no diagnosis, HTN, T2DM, or both). Descriptive statistics, non-parametric tests, and multivariable regression analyses were used to evaluate knowledge scores and predictors of CVD risk awareness. Results: A total of 458 participants completed the survey. Overall knowledge was moderate (mean 12.40/22; 56.4%), with relatively higher scores for HTN (73.2%) and T2DM knowledge (68.8%), but markedly lower CVD risk awareness (30.8%). Fewer than half of participants correctly answered key CVD items, particularly those related to asymptomatic disease progression and lipid (HDL) concepts. Only 21.6% achieved good awareness (≥75%). In multivariable analyses, higher educational level, positive family history of cardiometabolic disease, and the presence of HTN and/or T2DM were independent predictors of higher awareness. Conclusions: CVD risk awareness is suboptimal among adults in the Northern Border Region, including those with established HTN and T2DM. The observed gap between disease-specific knowledge and CVD risk awareness highlights the need for targeted, structured risk communication strategies in primary care, particularly for individuals with lower educational attainment and no family history of CVD.