Prevalence of atherosclerotic cardiovascular diseases (ASCVD) and associated factors among adults with cardio-metabolic risk factors attending chronic follow up care at non-communicable disease clinic, North East Ethiopia: multicenter hospital based cross-sectional study

Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality worldwide, contributing substantially to premature deaths and long-term disability. Despite advances in the management of non-communicable diseases, the burden of ASCVD continues to rise in low- and middle-income countries. (LMIC). In Ethiopia, evidence on the role of behavioural and cardiometabolic risk factors for ASCVD remains limited. This study aimed to assess the prevalence of ASCVD and its associated factors among adults with cardiometabolic risk factors attending chronic follow-up care at non-communicable disease clinics. A facility-based cross-sectional study was conducted from March 1,2025 to January 1, 2026 among adult with cardiometabolic risk factors having follow up at non-communicable disease clinic. Data on clinical, anthropometric, biochemical parameters were gathered from patient with self-administered questionnaires, laboratory, imaging test and from electronic medical records. Descriptive statistics, bivariate, and multivariable logistic regression analysis was performed to identify associated factors associated with ASCVD. A p-value of < 0.05 was considered statistically significant. The mean age of participants was 62 ± 12 years, with 50.5% female. The prevalence of ASCVD was 30.7%, comprising ischemic stroke (21.6%), ischemic heart disease (8.1%), and peripheral arterial disease (7.5%). ASCVD prevalence increased with age, rising from 4.5% in those < 55 years to 26.2% in older adults (AOR = 1.04; 95% CI: 1.032–1.07). Independent associated factors included rural residency, high salt intake, inadequate physical activity, long-standing hypertension, history of diabetes, poor blood pressure control, atrial fibrillation and low HDL. whereas high triglycerides, and obesity showed an inverse relationship. ASCVD was highly prevalent in this population. Age and other multiple behavioural and cardiometabolic factors were identified as risk. Rural residency emerged as an important determinant; together with inverse relation with triglycerides and obesity require further investigation. These findings underscore the urgent need for targeted prevention and early detection strategies, strengthening screening programs and improve control for HTN and DM to reduce the burden of ASCVD. Not applicable.