Cardiovascular disease knowledge, risk perception, and lifestyle behaviors among university students in North-Central Nigeria: a cross-sectional study.

backgroundCardiovascular diseases are a leading cause of mortality in Nigeria, with risk trajectories often established in early adulthood. While university students are a key population for prevention, a critical gap exists in understanding how their knowledge of CVD translates into personal risk perception and lifestyle intentions in the Nigerian context. This study investigated this nexus among students in North-Central Nigeria.

methodsWe conducted a cross-sectional study of 1,300 undergraduates from two universities using the validated ABCD Risk Questionnaire. The survey measured CVD knowledge (0-8 scale), perceived risk (8-32 scale), and behavioral intentions for exercise and diet. Data analysis employed descriptive statistics, independent t-tests, Pearson correlations, and multiple regression (α = 0.05).

resultsParticipants demonstrated moderate CVD knowledge (Mean = 6.21 ± 1.32 out of 8, 77.6% correct) yet exhibited significant gaps in understanding familial risk (56.9% correct) and alcohol's role (72.8% correct). A striking inverse relationship emerged: higher knowledge was significantly correlated with lower personal risk perception (r=-0.187, p < 0.001). Overall risk perception was low (Mean = 18.75 ± 4.88 out of 32, 58.6% of scale maximum), with 72.1% dismissing the likelihood of future CVD events. Paradoxically, this low-risk perception coexisted with high readiness for behavioral change, as 78.1% demonstrated high exercise readiness (Mean = 2.11 ± 0.64 on 1-4 scale, where lower scores indicate higher readiness) and 79.9% high dietary readiness (Mean = 2.27 ± 0.73). Self-reported smoking prevalence was 2.2% and alcohol use 3.6%. NSUK students reported slightly higher perceived risk than UNIJOS students (19.12 ± 4.95 vs. 18.43 ± 4.82, p = 0.012, Cohen's d = 0.14), though knowledge and behavioral intentions were comparable between universities.

conclusionsWe identify a "knowledge-risk paradox" among Nigerian university students: greater knowledge is inversely correlated with lower personal risk perception (r=-0.187, p < 0.001), an association suggesting potent optimistic bias. This disconnect indicates that conventional knowledge-based health education is likely insufficient. Public health interventions must pivot towards strategies that include personalized risk assessment to combat complacency and effectively channel the high pre-existing readiness for healthy lifestyle changes in this population.