Understanding Risk Perceptions Regarding Cardiovascular Disease Among Young Adults in Gilgit, Pakistan

Abstract

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide, disproportionately impacting low- and middle-income countries (LMICs) such as Pakistan, where mortality rates associated with CVD exceed the global average. Recent epidemiological shifts show increasing CVD incidence among younger populations. In the province of Gilgit-Baltistan (GB), where health infrastructure remains limited, CVD-related morbidity and mortality among young adults has been rising in recent years. Contributing factors among this demographic include widespread behavioral risks such as tobacco use, unhealthy dietary habits, and low levels of physical activity, along with a high prevalence of undetected and unmanaged hypertension. Objective: The study explores risk perceptions regarding CVD among young adults in Gilgit who have a baseline knowledge of CVD and its risk factors. It examines whether this knowledge translates into action and identifies perceived benefits and barriers to adopting CVD-preventive behaviors. Methods: The study employed a qualitative design using the Health Belief Model (HBM) as a theoretical framework. Semi-structured interviews were conducted in Urdu with 31 undergraduate students aged 19–25, enrolled at Karakoram International University (KIU), Gilgit. Participants were recruited via snowball sampling. Data was analyzed through thematic analysis, combining deductive and inductive approaches, using ATLAS.ti software. Results: Participants recognized CVD as a serious condition and expressed concern over its increasing incidence among young adults. However, most perceived their own risk as low, except those with a family history of CVD or personal health issues. Perceptions of CVD as a distant threat led to a low prioritization of preventive behaviors. Even among participants who acknowledged a higher personal risk, adopting healthy behaviors remained challenging. Barriers included academic stress, digital distractions, and religious beliefs. Social and familial influences served as both key motivators for behavior change and barriers in contexts where participants had limited control, such as shared family meals. Individual willpower emerged as an important internal driver, shaped by these external dynamics. Conclusion: Our findings highlight the need to develop culturally relevant, youth-centered interventions that promote CVD prevention by addressing both individual perceptions and broader social determinants of behavior.