The relationship of cardiovascular disease knowledge, health history and lifestyle factors with healthy lifestyle behaviors: A study in the context of university youth
2
Mersin University, Faculty of Education, Mersin, Turkiye
Abstract
The purpose of this study is to examine the relationships between university students’ healthy lifestyle behaviors and their knowledge and risk perception levels regarding cardiovascular diseases, and to identify the factors that predict healthy lifestyle behaviors. In this context, the predictive role of demographic variables, health history, lifestyle habits, and knowledge level about cardiovascular diseases on healthy lifestyle behaviors was evaluated. The research was conducted using data obtained from 489 full-time students aged 18 and over studying at a state university in the Mediterranean Region. A quantitative cross-sectional correlational design was adopted to examine the determinants of healthy lifestyle behaviours among university students. The data collection tools used in the study were the “Cardiovascular Disease Risk Factors Knowledge Level (CARRIF-KL) Scale” and the “Healthy Lifestyle Behaviors Scale-II (HLBS-II)”. The data were analyzed using Pearson correlation analysis and four-stage hierarchical multiple regression analysis. A preliminary power analysis was performed using the total R² value as a guide to determine the sample size required for hierarchical multiple regression. The findings showed that knowledge about cardiovascular diseases, awareness of risk factors, and cognitive awareness of the consequences of risky behaviors are important and positive predictors of healthy lifestyle behaviors. Furthermore, lifestyle habits such as smoking, consumption of processed foods, and frequent exposure to stress were found to be important negative predictors of these behaviors. In this regard, the study emphasizes the importance of both risk perception and informative interventions in promoting healthy lifestyle habits among young adults.
Aslan, T. V., & Bozkur, B. (2025). The relationship of cardiovascular disease knowledge, health history and lifestyle factors with healthy lifestyle behaviors: A study in the context of university youth. International Journal of Eurasia Social Sciences, 16(62), 2178–2193. https://doi.org/10.70736/ijoess.2031
📄Adams, V., Reich, B., Uhlemann, M., & Niebauer, J. (2017). Molecular effects of exercise training in patients with cardiovascular disease: focus on skeletal muscle, endothelium, and myocardium. American Journal of Physiology-Heart and Circulatory Physiology, 313(1), H72-H88. [Crossref]
📄Akman, M., & Civek, S. (2022). Dünyada ve Türkiye’de kardiyovasküler hastalıkların sıklığı ve riskin değerlendirilmesi. The Journal of Turkish Family Physician, 13(1), 21-28. [Crossref]
📄Ammar, A., Trabelsi, K., Hermassi, S., Kolahi, A. A., Mansournia, M., Jahrami, H., … et al. (2023). Global disease burden attributed to low physical activity in 204 countries and territories from 1990 to 2019: Insights from the Global Burden of Disease 2019 Study. Biology of Sport, 40(3), 835-855. [Crossref]
📄Anderson, L., Brown, J. P., Clark, A. M., Dalal, H., Rossau, H. K. K., Bridges, C., … et al. (2017). Patient education in the management of coronary heart disease. Cochrane Database of Systematic Reviews, (6). [Crossref]
📄Arıkan, İ., Metintaş, S., Kalyoncu, C., & Yıldız, Z. (2009). Kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi (KARRİF-BD) ölçeği’nin geçerlik ve güvenirliği. Türk Kardiyoloji Derneği Arşivi, 37(1), 35-40.
📄Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., … et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 74(10), 1376-1414. [Crossref]
📄Assaf, I., Brieteh, F., Tfaily, M., El-Baida, M., Kadry, S., & Balusamy, B. (2019). Students university healthy lifestyle practice: quantitative analysis. Health İnformation Science and Systems, 7(1), 1-12. [Crossref]
📄Awad, A., & Al-Nafisi, H. (2014). Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health, 14(1), 1131. [Crossref]
📄Badger, J., Quatromoni, P. A., & Morrell, J. S. (2019). Relationship between stress and healthy lifestyle factors of college students. Health Behavior and Policy Review, 6(1), 43-55. [Crossref]
📄Bahar, Z., Beşer, A., Gördes, N., Ersin, F., & Kıssal, A. (2008). Sağlıklı yaşam biçimi davranışları ölçeği II’nin geçerlik ve güvenirlik çalışması. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi, 12(1), 1-13.
📄
📄Barreto-Vega, A. M., Gaytán-Caycho, B. M., Newball-Noriega, E. E., & Huancahuire-Vega, S. (2025). Association of low knowledge about cardiovascular disease and lack of lifestyle changes after the COVID-19 pandemic with higher cardiovascular risk in Peruvian residents. Journal of Public Health Research, 14(3), 22799036251358296. [Crossref]
📄Chacko, M., Sarma, P. S., Harikrishnan, S., Zachariah, G., & Jeemon, P. (2020). Family history of cardiovascular disease and risk of premature coronary heart disease: A matched case-control study. Wellcome Open Res, 5, 70. [Crossref]
📄Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.
📄Coşkun, S. (2024). Yetişkin bireylerin kardiyovasküler hastalık risk faktörleri bilgi düzeyi ile sağlığı geliştirici ve koruyucu davranışlar arasındaki ilişkinin incelenmesi. Kardiyovasküler Hemşirelik Dergisi, 15(36), 8-16.
📄Çürük, G. N., Korkut Bayındır, S., & Oğuzhan, A. (2018). Kardiyovasküler hastalığı olan hasta ve hasta yakınlarında kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ve sağlıklı yaşam biçimi davranışları. Sağlık Bilimleri Dergisi (Journal of Health Sciences), 27(1), 40-47.
📄de-Mateo-Silleras, B., Camina-Martín, M. A., Cartujo-Redondo, A., Carreño-Enciso, L., de-la-Cruz-Marcos, S., & Redondo-del-Río, P. (2019). Health perception according to the lifestyle of university students. Journal of community health, 44(1), 74-80. [Crossref]
📄Demir Doğan, M., & Elik, B. (2024). University students’ knowledge level about risk factors for cardiovascular diseases, their healthy life awareness, and the influencing factors. Journal of Public Health, 32(4), 683-689. [Crossref]
📄Dimitriadis, N., Arnaoutis, G., Chrysohoou, C., Barkas, F., Liberopoulos, E., Sfikakis, P. P., … et al. (2025). Assessment of long-term engagement in aerobic versus resistance exercise on 20-year cardiovascular disease incidence (2002–2024): The ATTICA epidemiological cohort study. Journal of Clinical Medicine, 14(2), 522. [Crossref]
📄Dülek, H., Vural, Z. T., & Gönenç I. (2018). Risk factors in cardiovascular diseases. The Journal of Turkish Family Physician, 9(2), 53-58. [Crossref]
📄Escalante-Aburto, A., & Peña-Becerril, M. (2025). Integration of cardiovascular risk assessment as a strategy for awareness and habit ımprovement during university studies. In 2025 Institute for the Future of Education Conference (IFE) (pp. 1-6). IEEE. [Crossref]
📄Fan, M., Sun, D., Zhou, T., Heianza, Y., Lv, J., Li, L., … et al. (2020). Sleep patterns, genetic susceptibility, and incident cardiovascular disease: A prospective study of 385 292 UK biobank participants. European Heart Journal, 41(11), 1182-1189. [Crossref]
📄Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. [Crossref]
📄Field, A. (2009). Discovering statistics using SPSS: Book plus code for E version of text (Vol. 896). London, UK: SAGE Publications Limited.
📄Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., … et al. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise. 43, 1334–1359. [Crossref]
📄George, D., & Mallery, P. (2003). Frequencies. In D. George, & P. Mallery (Eds.), SPSS for Windows Step by Step: A simple Guideand Reference 11.0 Update (pp. 20–52). Pearson Education.
📄Giri, S, Sharma,S. R., Timalsina,S., Yadav, V., Koirala, S., Kumar, A., … et al. (2012). Cardiovascular health risk behavior among medical students in a teaching hospital. Journal of Nepal Health Research Council,10(3), 187-91. [Crossref]
📄Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis. 7th Edition, Pearson Education: Upper Saddle River.
📄Katzmarzyk, P. T., Friedenreich, C., Shiroma, E. J. & Lee, I. M. (2022). Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. British Journal of Sports Medicine, 56(2), 101–106. [Crossref]
📄Khani Jeihooni, A., Jormand, H., Saadat, N., Hatami, M., Abdul Manaf, R., Afzali Harsini, P. (2021). The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women. BMC Cardiovasc Disord, 21(1): 589. [Crossref]
📄Kotseva, K., De Backer, G., De Bacquer, D., Rydén, L., Hoes, A., Grobbee, D., … et al. (2019). Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. European Journal of Preventive Cardiology, 26(8), 824-835. [Crossref]
📄Liu, K., Daviglus, M. L., Loria, C. M., Colangelo, L. A., Spring, B., Moller, A. C., … et al. (2012). Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: the Coronary Artery Risk Development in (Young) Adults (CARDIA) study. Circulation, 125(8), 996-1004. [Crossref]
📄Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., … et al. (2010). Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation, 121(4), 586-613. [Crossref]
📄Magnussen, C., Ojeda, FM., Leong, DP., Alegre-Diaz, J., Amouyel, P., Aviles-Santa, L., … et al. (2023). Global effect of modifiable risk factors on cardiovascular disease and mortality. The New England Journal of Medicine, 389(14), 1273-85. [Crossref]
📄Maza-Ávila, F. J., Caneda-Bermejo, M. C., & Vivas-Castillo, A. C. (2022). Dietary habits and health effects among university students. A systematic review. Psicogente, 25(47), 110-140. [Crossref]
📄Mezhal, F., Ahmad, A., Abdulle, A., Leinberger-Jabari, A., AlJunaibi, A., Alnaeemi, A., … et al. (2025). Association of family history of cardiovascular disease with the prevalence of cardiometabolic risk factors in young adults in the United Arab Emirates: The UAE healthy future study. PLOS One, 20(3), e0319648. [Crossref]
📄Moonesinghe, R., Yang, Q., Zhang, Z., & Khoury, M. J. (2019). Prevalence and cardiovascular health impact of family history of premature heart disease in the United States: analysis of the National Health and Nutrition Examination Survey, 2007–2014. Journal of the American Heart Association, 8(14), e012364. [Crossref]
📄Mosca, L., Mochari, H., Christian, A., Berra, K., Taubert, K., Mills, T., … et al. (2006). National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation, 113(4), 525-534. [Crossref]
📄Perry, A. S., Dooley, E. E., Master, H., Spartano, N. L., Brittain, E. L., & Pettee Gabriel, K. (2023). Physical activity over the lifecourse and cardiovascular disease. Circulation Research, 132(12), 1725-1740. [Crossref]
📄Ruiz-Hernández, J. A., Guillén, Á.,Pina, D., & Puente-López, E. (2022). Mental health and healthy habits in university students: A comparative associative study. European Journal of İnvestigation in Health, Psychology and Education, 12(2), 114-126. [Crossref]
📄Santa-Rosa, F. A., Shimojo, G. L., Dias, D. S., Viana, A., Lanza, F. C., Irigoyen, M. C., … et al. (2020). Impact of an active lifestyle on heart rate variability and oxidative stress markers in offspring of hypertensives. Scientific Reports, 10(1), 12439. [Crossref]
📄Taylor, C. N., Wang, D., Larson, M. G., Lau, E. S., Benjamin, E. J., D’Agostino Sr, R. B., ... et al. (2023). Family history of modifiable risk factors and association with future cardiovascular disease. Journal of the American Heart Association, 12(6), e027881. [Crossref]
📄Teo, K., Lear, S., Islam, S., Mony, P., Dehghan, M., Li, W., ... & Pure Investigators. (2013). Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle-and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study. Jama, 309(15), 1613-1621. [Crossref]
📄van Oort S, Beulens J. W. J., van Ballegooijen A. J., Grobbee D. E., & Larsson S. C. (2020). Association of cardiovascular risk factors and lifestyle behaviors with hypertension. Hypertension, 76(6), 1971–9. [Crossref]
📄Visseren, F. L., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., ... et al. (2021). 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). European Heart Journal, 42(34), 3227-3337. [Crossref]
📄Walker, S. N., & Hill-Polerecky, D. M. (1996). Psychometric evaluation of the health-promoting lifestyle profile II. Unpublished manuscript, University of Nebraska Medical Center, 13, 120-6.
📄Wang, Y., Wang, Y., Shehzad, Q., Su, Y., Xu, L., Yu, L., ... et al. (2024). Does omega-3 PUFAs supplementation improve metabolic syndrome and related cardiovascular diseases? A systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition, 64(26), 9455-9482. [Crossref]
📄Wu, N., Wang, J., Hu, Y., Du, T., Shu, P., Shen, C., ... et al. (2025). Global burden of cardiovascular disease due to low physical activity, 1990–2021. Scientific Reports, 15(1), 25636. [Crossref]
📄Yadav, S., & Khokhar, A. (2021). Effect of information, education, and communication activity on health literacy of cardiovascular diseases among school-going adolescents in Delhi. Journal of Education and Health Promotion, 10(1), 71. [Crossref]
📄Yılmaz, F. T., Kumsar, A. K., & Çelik, S. (2018). Tip 2 diyabetli bireylerde kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ıle saglıklı yasam biçimi davranısları arasındaki ıliski. Hemşirelikte Eğitim ve Araştırma, 15(2), 63-70.
📄Zheng, H., Li, C., Zhang, L., Wang, T., Cai, Z., & Lei, M. (2024). Evaluation of depression and its correlates in terms of demographics, eating habits, and exercises among university students: a multicenter cross-sectional analysis. Neuropsychiatric Disease and Treatment, 20, 1079-1095. [Crossref]
📄Zhou, X. D., Cai, J., Targher, G., Byrne, C. D., Shapiro, M. D., Sung, K. C., ... et al. (2022). Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention. Cardiovascular Diabetology, 21(1), 270. [Crossref]
,
Binaz Bozkur
2
