Prevalence, knowledge, and associated factors of atherosclerotic cardiovascular disease risk factors among adults in Jimma Town, Ethiopia: a community-based cross-sectional study

Background Amidst the epidemiological transition in sub-Saharan Africa, atherosclerotic cardiovascular disease (ASCVD) is emerging as a critical public health challenge; however, comprehensive community-level data regarding risk factors, awareness, and preventive practices remain sparse in Ethiopia. To address this gap, this study evaluated the prevalence of ASCVD risk factors, associated knowledge levels, preventive behaviors, and correlated determinants among adults in Jimma Town. Methods A community-based cross-sectional study was conducted among 332 adults aged ≥ 18 years in Jimma Town between 1 and 28 November 2021. Data were collected on sociodemographic characteristics, lifestyle behaviours, anthropometric measurements, blood pressure, random blood glucose, and knowledge of ASCVD risk factors using a 10-item instrument. Binary and multivariable logistic regression identified factors associated with the principal outcomes (moderate physical activity, alcohol use, smoking exposure, khat chewing, hypertension-range blood pressure, central obesity, and good ASCVD knowledge); variables with p ≤ 0.25 in bivariate analysis were entered into multivariable models. Results Among the evaluated adult cohort (mean age 40.7 years; 56.3% female), the findings indicate a substantial cardiometabolic risk burden, characterized by high rates of hypertension-range blood pressure (44.6%), central obesity (42.9%, predominantly in women), and hyperglycemia (5.8%). Only 27.4% of participants achieved at least 150 min of moderate-intensity physical activity per week, alongside prevalent alcohol consumption (17.8%), smoking exposure (11.4%), and habitual khat chewing (19.9%), even though 56.3% of participants demonstrated good ASCVD risk factor knowledge. Furthermore, multivariable analyses revealed that moderate physical activity ≥ 150 min/week was associated with male sex (AOR = 2.05, 95% CI 1.23–3.42), usual khat chewing with male sex (AOR = 18.23, 95% CI 8.02–41.42) and younger age, alcohol use with age ≥ 45 years (AOR = 2.31, 95% CI 1.22–4.37) and medium/high income (AOR = 3.09, 95% CI 1.63–5.85), and good ASCVD knowledge was less likely among habitual khat chewers (AOR = 0.46, 95% CI 0.26–0.82) and those who routinely added salt to meals (AOR = 0.45, 95% CI 0.23–0.87). Conclusions Adults in Jimma Town had a substantial burden of hypertension-range blood pressure, central obesity, and selected adverse lifestyle behaviors, which were further compounded by a gap in recognition of specific ASCVD risk factors and preventive practices. These findings underscore the need for multifaceted community-level public health interventions that synergize systematic risk screening with targeted educational programs to mitigate modifiable behavioral determinants, including physical inactivity, substance use, and poor dietary habits. Clinical trial registration Not applicable. This was a community-based cross-sectional observational study and did not involve a clinical trial or prospective assignment of participants to an intervention.