Awareness of heart disease risk factors is associated with healthy lifestyle practices among household heads in the Philippines

Ischemic heart disease is the leading cause of mortality in the Philippines. While awareness of modifiable risk factors is promoted, their translation into healthy practices remains unclear, with limited evidence on how this relationship varies across socioeconomic groups. This study examined the association between awareness of six behavioral risk factors for heart disease (excessive alcohol consumption, lack of sleep, smoking, physical inactivity, elevated blood pressure, and unhealthy diet) and engagement in corresponding healthy lifestyle practices among Filipino household heads. We analyzed data from 14,936 household heads aged ≥ 20 years from the 2022 Philippines Demographic and Health Survey. Exposure variables included awareness of risk factors, while the outcome variables included engagement in related healthy lifestyle practices. Associations were estimated using binary logistic regression, with stratified analyses by wealth index. Overall awareness of heart disease risk factors was generally low, with smoking (37.94%), unhealthy diet (35.75%), and elevated blood pressure (33.72%) most commonly recognized, while lack of sleep (7.00%) was the least recognized. Engagement in healthy lifestyle practices was similarly low, with being physically active (40.02%) most reported and blood pressure monitoring (1.63%) least practiced. Awareness was consistently associated with higher engagement across all risk factors. The strongest association was observed between awareness of excessive alcohol risk and safer drinking behaviors (i.e., avoiding excessive intake or drinking moderately). (aOR: 2.13; 95% CI: 1.88–2.43). Stratified analyses showed consistent associations across wealth quintiles, except for elevated blood pressure awareness, which was only significant among the richest (aOR: 1.66; 95% CI: 1.04–2.64). Awareness of heart disease risk factors among Filipino household heads remains low but is significantly associated with healthy lifestyle practices. Associations between awareness and health behaviors were generally consistent across wealth quintiles; however, awareness was linked to blood pressure monitoring only in the highest quintile, suggesting the need for equitable access to preventive services.