Lifestyle risks in a very high-risk european region: prevalence of modifiable cardiovascular factors in the adult population

Abstract Background Cardiovascular diseases remain the leading cause of mortality and morbidity worldwide. Lifestyle-related behaviours, including diet quality, physical inactivity, and sleep disturbance, substantially influence cardiometabolic risk, yet population-level data on these patterns remain limited in many regions undergoing rapid socio-economic transition. Purpose To assess the prevalence of behavioural and dietary cardiovascular risk factors in a general adult population using a structured observational survey. Methods A 55-item online questionnaire was distributed to adults residing in Romania to collect information on sociodemographic characteristics, anthropometric measures, dietary intake, physical activity, smoking habits, sleep patterns, perceived health risks, medical check-up behaviour, supplement use, and self-reported cardiovascular status. The survey ensured anonymity and adherence to data-protection principles. Descriptive analyses were used to characterise the distribution of lifestyle-related risk factors. Results A total of 1,264 respondents completed the questionnaire, of whom 849 were women (67.2%) were women and 415 (32.8%) were men, with a mean age of 45.5 years (46.3 years in men and 45.2 years in women). Excess body weight was highly prevalent, with 62.6% classified as overweight or obese, while only 34.8% reported a normal body mass index. Physical inactivity was common, with 30.2% indicating no regular activity. Dietary quality was suboptimal: 39% consumed two daily portions of vegetables, 39.2% consumed only one portion of fruit, and 24% reported daily consumption of processed foods. Elevated blood pressure was self-reported by 33.9% of participants. Short sleep duration (7 hours per night) was more frequent among individuals with excess body weight. Stress was perceived as the dominant contributor to declining health (67.6%), followed by excessive workload (36.4%) and poor sleep quality (34.7%). Conclusions This survey highlights a clustering of behavioural, dietary, and psychosocial risk factors that frequently co-occur, suggesting that cardiovascular vulnerability in the general population is driven not by single behaviours but by accumulated lifestyle patterns. The identification of distinct high-risk profiles, including the combined presence of excess body weight, inactivity, poor diet quality, and short sleep, offers an opportunity to shift prevention strategies from isolated recommendations to integrated, behaviour-pattern interventions. These findings provide a foundation for designing precision public health approaches that more effectively target groups with overlapping lifestyle risks, thereby enhancing the impact of cardiovascular prevention efforts.