{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:05:05Z","timestamp":1790103905261,"version":"4.0.1"},"reference-count":44,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":83,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,9,1]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cardiovascular diseases (CVDs) are increasingly affecting young adults globally, particularly in developing countries where lifestyle transitions during early adulthood contribute to the early accumulation of CVD risk factors. Identifying these risks at a younger age provides an opportunity to prevent irreversible disease. This study aimed to identify CVD risk and its associated factors among university students in Punjab, India, using a validated non-laboratory-based risk assessment tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A descriptive cross-sectional study was conducted in March 2025 among university students in Punjab, India, using purposive sampling. CVD risk was assessed using the non-laboratory-based Health Metrics Risk Score (HMRS) questionnaire. Descriptive and inferential statistics were used to analyse the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 420 participants, 282 (67.1%; 95% CI 62.4% to 71.6%) were classified as having low CVD risk, while 138 (32.9%; 95% CI 28.4% to 37.6%) had moderate\/high CVD risk. Common risk-related behaviours included physical inactivity (35.0%), frequent consumption of deep-fried\/fast foods (46.4%), daily consumption of salty foods (30.5%), overweight\/obesity (20.0%) and exposure to secondhand smoke (12.9%). In multivariable analysis, living with friends (adjusted OR (AOR)=3.12, 95% CI 1.28 to 7.57), smoking (AOR=9.86, 95% CI 1.13 to 86.14), secondhand smoke exposure (AOR=3.70, 95% CI 1.67 to 8.18), alcohol\/hazardous alcohol use (AOR=2.84, 95% CI 1.14 to 7.04), frequent consumption of deep-fried\/fast foods (AOR=2.05, 95% CI 1.20 to 3.49), daily fruit consumption (AOR=3.55, 95% CI 1.73 to 7.29), higher meat\/poultry intake (AOR=6.93, 95% CI 3.85 to 12.49) and physical activity (AOR=5.64, 95% CI 2.92 to 10.86) were associated with increased odds of moderate\/high CVD risk. Daily vegetable consumption was associated with reduced odds of moderate\/high CVD risk (AOR=0.27, 95% CI 0.12 to 0.59).\n                      <jats:bold>Conclusion:<\/jats:bold>\n                      Nearly one-third of young adults carried moderate-to-high CVD risk, emphasising the urgent need for early, targeted preventive interventions addressing lifestyle and mental health\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2026-005008","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:33Z","timestamp":1790102133000},"page":"e005008","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular disease risk and its behavioural correlates among university students in Punjab, India: a cross-sectional analytical study"],"prefix":"10.1136","volume":"4","author":[{"given":"Daljit","family":"Kaur","sequence":"first","affiliation":[{"name":"Collge of Nursing, SPHE College of Nursing, Sarasawthi Group of Colleges, Mohali, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya K","family":"Ravi","sequence":"additional","affiliation":[{"name":"College of Nursing, RAK Medical & Health Sciences University, Ras Al Khaimah, Ras Al Khaimah, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Sharma","sequence":"additional","affiliation":[{"name":"Collge of Nursing, SPHE College of Nursing, Sarasawthi Group of Colleges, Mohali, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Varghese","sequence":"additional","affiliation":[{"name":"College of Nursing, Fatima College of Nursing, Fatima College of Health Sciences, Al Dhafra, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad U","family":"Rehman","sequence":"additional","affiliation":[{"name":"School of Public Policy and Administration, Xi\u2019an Jiaotong University, Xi\u2019an, Shaanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Baby","sequence":"additional","affiliation":[{"name":"College of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4783-5369","authenticated-orcid":false,"given":"Jaison","family":"Jacob","sequence":"additional","affiliation":[{"name":"College of Nursing, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4248-1407","authenticated-orcid":false,"given":"Lakshmi","family":"Ramamoorthy","sequence":"additional","affiliation":[{"name":"College of Nursing, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092211352417000_4.3.e005008.1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph22040539","article-title":"Prevalence of CVD Among Indian Adult Population: Systematic Review and Meta-Analysis","volume":"22","author":"Shannawaz","year":"2025","journal-title":"Int J Environ Res Public Health"},{"key":"2026092211352417000_4.3.e005008.2","doi-asserted-by":"crossref","first-page":"e351","DOI":"10.1016\/j.jacl.2024.01.006","article-title":"Lipid Association of India 2023 update on cardiovascular risk assessment and lipid management in Indian patients: Consensus statement IV","volume":"18","author":"Puri","year":"2024","journal-title":"J Clin Lipidol"},{"key":"2026092211352417000_4.3.e005008.3","doi-asserted-by":"crossref","DOI":"10.1186\/s43044-021-00219-9","article-title":"Cardiovascular disease risk factors among undergraduate medical students in a tertiary care centre of eastern India: a pilot study","volume":"73","author":"Mukhopadhay","year":"2021","journal-title":"Egypt Heart J"},{"key":"2026092211352417000_4.3.e005008.4","doi-asserted-by":"crossref","first-page":"288","DOI":"10.71164\/socialmedicine.v18i3.2025.1747","article-title":"A Study to Assess the Effect of Health Promotion Intervention on Knowledge Regarding Prevention of Coronary Artery Disease Among College Students in Selected Colleges at Alappuzha, District in Kerala, India","volume":"18","year":"2025","journal-title":"SM"},{"key":"2026092211352417000_4.3.e005008.5","doi-asserted-by":"crossref","first-page":"2558","DOI":"10.4103\/jfmpc.jfmpc_2415_20","article-title":"Prevalence and predictors of prehypertension and hypertension in adult population of rural Southern India-An epidemiological study","volume":"10","author":"Udayar","year":"2021","journal-title":"J Family Med Prim Care"},{"key":"2026092211352417000_4.3.e005008.6","doi-asserted-by":"crossref","first-page":"752","DOI":"10.4103\/ijmr.IJMR_678_17","article-title":"A cross-sectional study on pre-hypertension & its association with anthropometric indices among undergraduate medical students in Andhra Pradesh, India","volume":"148","author":"Bhavani","year":"2018","journal-title":"Indian J Med Res"},{"key":"2026092211352417000_4.3.e005008.7","doi-asserted-by":"crossref","first-page":"5463","DOI":"10.21276\/SSR-IIJLS.2024.10.3.9","article-title":"Investigation of Risk Factors and Prevalence of Hypertension among Young Adults in Urban and Suburban Population of Central India","volume":"10","author":"Jain","year":"2024","journal-title":"SSR-IIJLS"},{"key":"2026092211352417000_4.3.e005008.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-021-10554-w","article-title":"Life-course leisure-time physical activity trajectories in relation to health-related behaviors in adulthood: the Cardiovascular Risk in Young Finns study","volume":"21","author":"Lounassalo","year":"2021","journal-title":"BMC Public Health"},{"key":"2026092211352417000_4.3.e005008.9","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1007\/s10865-020-00161-2","article-title":"Associations of leisure screen time with cardiometabolic biomarkers in college-aged adults","volume":"43","author":"Vella","year":"2020","journal-title":"J Behav Med"},{"key":"2026092211352417000_4.3.e005008.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-12728-6","article-title":"Sedentary time and its association with risk of cardiovascular diseases in adults: an updated systematic review and meta-analysis of observational studies","volume":"22","author":"Jingjie","year":"2022","journal-title":"BMC Public Health"},{"key":"2026092211352417000_4.3.e005008.11","doi-asserted-by":"crossref","first-page":"450","DOI":"10.4103\/ijcm.IJCM_682_20","article-title":"Assessment of Preventable Risk Factors of Cardiovascular Diseases among Junior College Students: A Cross-Sectional Study","volume":"46","author":"Hadaye","year":"2021","journal-title":"Indian J Community Med"},{"key":"2026092211352417000_4.3.e005008.12","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2025.101676","article-title":"Primary Prevention of Cardiovascular Disease in Asia: Opportunities and Solutions: A Narrative Review","volume":"4","author":"Dalakoti","year":"2025","journal-title":"JACC Adv"},{"key":"2026092211352417000_4.3.e005008.13","doi-asserted-by":"crossref","DOI":"10.1016\/j.lansea.2023.100156","article-title":"The burgeoning cardiovascular disease epidemic in Indians - perspectives on contextual factors and potential solutions","volume":"12","author":"Kalra","year":"2023","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"2026092211352417000_4.3.e005008.14","doi-asserted-by":"crossref","first-page":"31","DOI":"10.37506\/kr5xqx41","article-title":"A Cross-Sectional Survey to Assess the Risk Factors of Cardio Vascular Disease among College Students","volume":"16","author":"Jafar Ali","year":"2024","journal-title":"IJONE"},{"key":"2026092211352417000_4.3.e005008.15","doi-asserted-by":"crossref","first-page":"757","DOI":"10.4103\/jfmpc.jfmpc_1419_24","article-title":"Prevalence and associated risk factors of hypertension in rural and urban areas of Punjab: A cross-sectional study","volume":"14","author":"Singh","year":"2025","journal-title":"J Family Med Prim Care"},{"key":"2026092211352417000_4.3.e005008.16","doi-asserted-by":"crossref","first-page":"23","DOI":"10.4103\/ijcm.ijcm_672_21","article-title":"A Community-Based Noncommunicable Disease Prevention Intervention in Punjab, India","volume":"47","author":"Jaacks","year":"2022","journal-title":"Indian J Community Med"},{"key":"2026092211352417000_4.3.e005008.17","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.768471","article-title":"Prevalence, Awareness, Treatment, and Control of Hypertension and Diabetes: Results From Two State-Wide STEPS Survey in Punjab and Haryana, India","volume":"10","author":"Thakur","year":"2022","journal-title":"Front Public Health"},{"key":"2026092211352417000_4.3.e005008.18","doi-asserted-by":"crossref","first-page":"e1339","DOI":"10.1016\/S2214-109X(18)30407-8","article-title":"The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990\u20132016","volume":"6","author":"Prabhakaran","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2026092211352417000_4.3.e005008.19","doi-asserted-by":"crossref","first-page":"520","DOI":"10.4103\/ijph.ijph_1747_22","article-title":"Comparison of Prevalence of Metabolic Disorders of Urban and Rural Adults of Punjab, India","volume":"67","author":"Bakhetia","year":"2023","journal-title":"Indian J Public Health"},{"key":"2026092211352417000_4.3.e005008.20","doi-asserted-by":"crossref","DOI":"10.1136\/bmjph-2023-000389","article-title":"Burden, determinants and treatment status of metabolic syndrome among older adults in India: a nationally representative, community-based cross-sectional survey","volume":"1","author":"Basu","year":"2023","journal-title":"BMJ Public Health"},{"key":"2026092211352417000_4.3.e005008.21","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.gheart.2016.11.004","article-title":"20-Year Trend of CVD Risk Factors: Urban and Rural National Capital Region of India","volume":"12","author":"Prabhakaran","year":"2017","journal-title":"Glob Heart"},{"key":"2026092211352417000_4.3.e005008.22","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1177\/0282423X241277054","article-title":"Extending Cochran\u2019s Sample Size Rule to Stratified Simple Random Sampling with Applications to Audit Sampling","volume":"41","author":"Qing","year":"2025","journal-title":"J Off Stat"},{"key":"2026092211352417000_4.3.e005008.23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/bimj.19650070312","article-title":"G.: Sampling Techniques, 2. Aufl","volume":"7","author":"Heinisch","year":"1963","journal-title":"Biom Z"},{"key":"2026092211352417000_4.3.e005008.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-084454","article-title":"Risk of cardiovascular diseases among young adults: a cross-sectional study in Malaysia","volume":"14","author":"Azzani","year":"2024","journal-title":"BMJ Open"},{"key":"2026092211352417000_4.3.e005008.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-030594","article-title":"Assessing the global risk of cardiovascular disease among a group of university students: population-based cross-sectional study in Yaound\u00e9, Cameroon","volume":"9","author":"Nansseu","year":"2019","journal-title":"BMJ Open"},{"key":"2026092211352417000_4.3.e005008.26","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311609"},{"key":"2026092211352417000_4.3.e005008.27","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq448"},{"key":"2026092211352417000_4.3.e005008.28","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/acer.15245","article-title":"High test\u2013retest reliability of the Alcohol Use Disorders Identification","volume":"48","author":"Simon","year":"2024","journal-title":"Alcohol, Clinical and Experimental Research"},{"key":"2026092211352417000_4.3.e005008.29","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.16.1789"},{"key":"2026092211352417000_4.3.e005008.30","unstructured":"Global Adult Tobacco Survey (GATS) . Core questionnaire with optional questions. 2020."},{"key":"2026092211352417000_4.3.e005008.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12966-017-0636-2","article-title":"A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study","volume":"15","author":"Dowd","year":"2018","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2026092211352417000_4.3.e005008.32","unstructured":"Global physical activity questionnaire analysis guide gpaq analysis guide global physical activity questionnaire (gpaq) analysis guide. 2012."},{"key":"2026092211352417000_4.3.e005008.33","doi-asserted-by":"crossref","unstructured":"Yadav N , Kasaudhan S , Dahal S , et al . Prevalence and determinants of physical activity and sedentary behavior: a population-based, cross-sectional study in rural Punjab, North India. J Public Health (Berl) 2025. doi:10.1007\/s10389-025-02449-6","DOI":"10.1007\/s10389-025-02449-6"},{"key":"2026092211352417000_4.3.e005008.34","unstructured":"Zierle-Ghosh A , Jan A . Physiology, Body Mass Index. 2025."},{"key":"2026092211352417000_4.3.e005008.35","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3390\/obesities4010004","article-title":"Assessment of Body Mass Index, Body Composition, Physical Activity, and Dietary Preferences in University Students: A Pilot Study","volume":"4","author":"Pet\u0159ekov\u00e1","year":"2024","journal-title":"Obesities"},{"key":"2026092211352417000_4.3.e005008.36","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.39282","article-title":"Prevalence of and Factors Associated With High Blood Pressure Among Adolescents in India","volume":"5","author":"Vasudevan","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026092211352417000_4.3.e005008.37","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(04)17018-9"},{"key":"2026092211352417000_4.3.e005008.38","doi-asserted-by":"crossref","first-page":"372","DOI":"10.4103\/ijem.ijem_155_22","article-title":"High Prevalence of Additional Cardiovascular Risk Factors in Eastern-Indian Young Adults with Type 2 Diabetes Mellitus","volume":"26","author":"Barure","year":"2022","journal-title":"Indian J Endocrinol Metab"},{"key":"2026092211352417000_4.3.e005008.39","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.2307"},{"key":"2026092211352417000_4.3.e005008.40","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajpc.2023.100612","article-title":"Atherosclerotic cardiovascular disease events among adults with high predicted risk without established risk factors","volume":"17","author":"Kong","year":"2024","journal-title":"Am J Prev Cardiol"},{"key":"2026092211352417000_4.3.e005008.41","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-023-03165-3","article-title":"High prevalence of cardiometabolic risk factors amongst young adults in the United Arab Emirates: the UAE Healthy Future Study","volume":"23","author":"Mezhal","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"2026092211352417000_4.3.e005008.42","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02925-4"},{"key":"2026092211352417000_4.3.e005008.43","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109191"},{"key":"2026092211352417000_4.3.e005008.44","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2020.00069","article-title":"Clustering and Tracking the Stability of Biological CVD Risk Factors in Adolescents: The Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs)","volume":"8","author":"Thangiah","year":"2020","journal-title":"Front Public Health"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2026-005008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:38Z","timestamp":1790102138000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2026-005008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,22]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2026-005008"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2026-005008","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}