Determinants Influencing Cardiovascular Health Behavior Change among Adults: A Narrative Review

Abstract

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, with a disproportionately high burden in low- and middle-income countries. Despite strong evidence supporting lifestyle modification, the adoption of cardiovascular health-promoting behaviors remains suboptimal. This narrative review aimed to synthesize evidence on determinants influencing cardiovascular health behavior change among adults. A comprehensive search of PubMed, MEDLINE, CINAHL, Google Scholar, and Research Gate was conducted for studies published between 2020 and 2024. Original quantitative, qualitative, and mixed-methods studies involving adults and examining the determinants of cardiovascular health behavior change were included. Titles, abstracts, and full texts were screened according to predefined eligibility criteria, and methodological quality was assessed using the Critical Appraisal Skills Program checklist. Eighteen studies met inclusion criteria. The findings suggest that cardiovascular health behavior change is a complex process influenced by interacting cognitive, behavioral, socio-economic, psychosocial, healthcare, and biological determinants. While knowledge improved awareness, sustained behavior change depended on risk perception, social support, healthcare access, and favorable socio-economic conditions. Overall, cardiovascular health behavior change is a complex process requiring multilevel interventions.