Sociodemographic Correlates and Prevalence of Modifiable Cardiovascular Disease Risk Factors Among University Students in North-Central Nigeria: A Cross-Sectional Study

Background: Cardiovascular diseases (CVDs) are increasingly affecting young adults in sub-Saharan Africa, yet evidence on demographic variations in risk factor prevalence among university students remains limited. Understanding "who" is most at risk is crucial for designing targeted prevention programs. This study examined sociodemographic correlates and prevalence of modifiable CVD risk factors among Nigerian university students. Methods: We conducted a cross-sectional study of 1,300 undergraduates from two universities in North-Central Nigeria between January and April 2025. Data were collected using the validated ABCD Risk Questionnaire supplemented with sociodemographic and behavioral risk factor assessments. Outcomes included CVD knowledge, risk perception, behavioral intentions, and prevalence of smoking, alcohol use, hypertension, diabetes, and family history of CVD. Statistical analyses employed chi-square tests, independent t-tests, ANOVA, Pearson correlations, and multiple linear regression. Results: The prevalence of modifiable risk factors was: current smoking 2.2%, current alcohol use 3.7%, self-reported hypertension 6.7%, diabetes 1.4%, and family history of CVD 14.6%. Risk factor clustering was minimal, with 83.7% having no behavioral risk factors. Significant demographic variations emerged: In Nasarawa State University, males had 6.3% lower CVD knowledge than females (p=0.002), while Muslims scored 5.9% lower than Christians (p=0.008). Religion significantly predicted risk perception, with Muslims perceiving 2.4% higher risk than Christians (β=2.361, p=0.007). Academic level negatively predicted exercise intentions (β=-1.228, p=0.003), with higher-level students showing lower readiness. CVD knowledge positively correlated with exercise intentions (r=0.231, p<0.001) and healthy eating intentions (r=0.138, p<0.001), but not with risk perception (r=-0.019, p=0.499). Overall, sociodemographic variables explained limited variance: knowledge (R²=1.1-4.4%), risk perception (R²=1.8%), exercise intentions (R²=2.1%), and dietary intentions (R²=0.7%). Conclusions: Nigerian university students exhibit inadequate CVD knowledge and low personal risk perception despite high readiness for healthy lifestyle changes. Critically, knowledge correlates with behavioral intentions but not with risk perception, revealing a selective disconnect where cognitive understanding translates into positive behavioral attitudes but not into personal vulnerability awareness. Public health interventions must address knowledge deficits through targeted education while simultaneously employing personalized risk assessment strategies to enhance risk awareness. The positive knowledge-behavior relationship provides a foundation for intervention, but the knowledge-risk perception disconnect requires deliberate strategies to calibrate personal risk awareness and effectively channel the existing high readiness for behavioral change. Trial registration: Not applicable.