Cardiovascular Health
Modifiable Risk Factors of Cardiovascular Disease Among Adults in Rural Community of Malaysia: A Cross-Sectional Study
Last reviewed: March 2026
Key Findings
- The study identified a high prevalence of modifiable cardiovascular disease risk factors — including hypertension, diabetes, dyslipidaemia, obesity, physical inactivity, and smoking — among adults in a rural Malaysian community.
- Hypertension was the most prevalent modifiable risk factor, affecting a substantial proportion of the adult population, with many cases previously undiagnosed prior to the study screening.
- Obesity and overweight were highly prevalent, with females showing higher rates of obesity while males had higher rates of smoking, demonstrating clear gender-specific risk profiles.
- The findings highlighted the urgent need for community-based CVD prevention programmes in rural Malaysia, targeting modifiable risk factors through lifestyle education, screening, and early intervention.
Background and Context
Cardiovascular disease (CVD) is the leading cause of death globally and in Malaysia, accounting for a significant proportion of total mortality and morbidity. The Global Burden of Disease Study has consistently ranked ischaemic heart disease and stroke among the top causes of death in Malaysia, and projections indicate that the CVD burden will continue to increase as the population ages and lifestyle risk factors become more prevalent.
The majority of cardiovascular disease burden is attributable to modifiable risk factors — conditions and behaviours that can be prevented, controlled, or reversed through individual behaviour change and population-level interventions. The major modifiable risk factors for CVD include hypertension, diabetes mellitus, dyslipidaemia, obesity, physical inactivity, unhealthy diet, and tobacco use. The prevalence of these risk factors in a given population provides a critical indicator of future CVD burden and an evidence base for prevention planning.
While national-level surveys such as the National Health and Morbidity Survey (NHMS) provide overall prevalence estimates for CVD risk factors, community-level studies are essential for understanding the specific risk profiles of local populations and for designing contextually appropriate interventions. Rural communities in Malaysia, which may face distinct patterns of risk factors related to their socioeconomic conditions, dietary patterns, and healthcare access, have been relatively less studied compared to urban populations.
This study, published in Volume 16, Issue 1 of the Malaysian Journal of Public Health Medicine in 2016, assessed the prevalence and distribution of modifiable CVD risk factors among adults in a rural community setting in Malaysia.
Study Design and Methods
The study employed a cross-sectional design involving adult residents of a rural community in Malaysia. Data collection involved health screening activities including measurement of blood pressure, fasting blood glucose, lipid profiles, anthropometric parameters (height, weight, waist circumference, and BMI), and administration of structured questionnaires assessing lifestyle factors including physical activity levels, dietary habits, and tobacco use.
Hypertension was defined according to established clinical guidelines as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or current use of antihypertensive medication. Diabetes mellitus was defined as fasting blood glucose ≥7.0 mmol/L or current use of glucose-lowering medication. Dyslipidaemia was identified based on abnormal lipid profile values. Obesity was classified using WHO BMI cut-off points, with additional assessment of abdominal obesity using waist circumference measurements.
Prevalence of Modifiable Risk Factors
The study revealed a high burden of modifiable CVD risk factors in the rural community. Hypertension was the most prevalent risk factor, consistent with national data indicating that approximately 40% of Malaysian adults are hypertensive. Alarmingly, a substantial proportion of hypertensive individuals identified during screening had been previously undiagnosed, indicating significant gaps in detection and awareness even in communities with access to primary healthcare services.
Overweight and obesity were highly prevalent, with approximately half of adults meeting criteria for overweight or obesity. This finding aligned with national-level data from the 2015 NHMS, which reported that 51.2% of Malaysian adults were overweight or obese. The prevalence of obesity was higher among females, consistent with the gender-specific patterns reported in other Malaysian studies and attributable in part to biological, lifestyle, and sociocultural factors that influence body weight differently in men and women.
Diabetes and dyslipidaemia were also identified at concerning levels, often co-existing with hypertension and obesity in the same individuals — reflecting the metabolic syndrome clustering of CVD risk factors. Physical inactivity was common, with many adults failing to meet recommended levels of moderate to vigorous physical activity. Smoking was primarily a male risk factor, with prevalence rates among men substantially higher than among women.
| Risk Factor | Prevalence Pattern |
|---|---|
| Hypertension | Most prevalent; many cases previously undiagnosed |
| Overweight/Obesity | ~50% of adults; higher obesity rates in females |
| Diabetes mellitus | Notable prevalence; often co-existing with other risk factors |
| Dyslipidaemia | Common; frequently clustered with metabolic syndrome |
| Physical inactivity | Widespread; below recommended activity levels |
| Smoking | Predominantly male; significant prevalence |
Gender-Specific Risk Profiles
The analysis revealed distinct gender-specific CVD risk profiles. Women in the study population were more likely to be obese, physically inactive, and to have abdominal obesity, while men were more likely to be smokers and to have dyslipidaemia. These gender-specific patterns have important implications for the design of CVD prevention programmes, which should address the distinct risk factor profiles and health behaviours of men and women through tailored messaging and intervention strategies.
Implications for Rural Community Health
The high prevalence of modifiable CVD risk factors in this rural community underscored the urgent need for comprehensive, community-based prevention programmes. Key recommended interventions included regular community health screening campaigns to detect hypertension, diabetes, and dyslipidaemia early; health education programmes promoting healthy dietary practices, regular physical activity, and smoking cessation; and strengthening of primary healthcare services to provide ongoing management and follow-up for individuals with identified risk factors.
The integration of NCD screening and management into existing primary healthcare programmes, supported by community health workers trained in health promotion and basic screening, was identified as a practical and sustainable approach for rural settings where specialist healthcare resources may be limited.
Limitations
The cross-sectional design precluded assessment of temporal trends or causal relationships. The study was conducted in a single rural community, and findings may not be representative of all rural populations in Malaysia, which are diverse in terms of ethnicity, economic activities, and healthcare access. Self-reported data on lifestyle factors such as physical activity and dietary intake may be subject to reporting bias. The study did not include follow-up to assess whether screening-identified risk factors led to clinical intervention and improved outcomes.
Significance for Malaysian Public Health
This study contributed important community-level evidence on the CVD risk factor burden in rural Malaysia, complementing national survey data with local detail. The findings reinforced the case for sustained investment in community-based NCD prevention programmes and highlighted the persistent gaps in risk factor detection and management in rural settings. As Malaysia continues to pursue its National Strategic Plan for Non-Communicable Diseases, research such as this provides the granular evidence needed to design and target interventions where they are most needed.
Modifiable risk factors of cardiovascular disease among adults in rural community of Malaysia: a cross-sectional study. Malaysian Journal of Public Health Medicine. 2016;16(1).