Prevalence and Correlates of Ideal Cardiovascular Health among Ugandan Adolescents: A Cross-Sectional Study

Introduction: Cardiovascular disease (CVD) risk factors often emerge during adolescence and track into adulthood, yet data on cardiovascular health (CVH) in sub-Saharan Africa remain limited. We assessed the prevalence and correlates of ideal CVH among Ugandan adolescents. Methods: We analysed baseline data of adolescents enrolled in a cluster-randomised controlled trial being conducted in urban (Kampala) and rural (Jinja) districts of Uganda. In this study, Ideal CVH was defined as meeting "ideal" status of 5-7 of the American Heart Association's Life's Simple 7 metrics. Random-effects logistic regression was used to identify factors associated with ideal CVH, accounting for village-level clustering. Results: We recruited 1316 participants with a mean age of 13.2 years, of whom 58.1% were female. Overall, the prevalence of ideal CVH was 66.8% (95% CI: 64.2% - 69.3%). The prevalence was higher in Jinja (74.4%, 95%CI: 70.9% - 77.7%) than Kampala (59.6%, 95%CI: 55.8%-63.2%) and the difference was evident (p<0.001). Male adolescents had higher odds of ideal CVH than females in both rural (aOR=1.55, 95%CI: 1.05-2.29) and urban (aOR=1.90, 95%CI: 1.38-2.63) settings. Increasing age and higher education level were associated with lower odds of ideal CVH in both settings, likely reflecting age-related behavioural changes. Conclusion: More than half of Ugandan adolescents have ideal CVH, with disparities by sex, age, and urbanisation. These findings suggest that cardiovascular health declines during adolescence and highlight the need for early, targeted interventions, particularly among female and urban adolescents.