The sociodemographic characteristics considered in this study were the respondents’ residence, gender, age, education, marital status, occupation, religion, health insurance ownership, social category, monthly income and family history of CVDs.

Research findings in Table 1 indicate that 83.6% of respondents were coming from urban zones, 61.5% were females, 53.6% were aged between 18 and 35 years (average age: 36.4 years, SD: 13.1, minimum age: 18 and maximum age: 86), 57.3% had primary educational level, 62.8% were married, 40.9% were self-employed, 45.8% were protestants, 90.4% owned health insurance, 48.2% were in the third social category and 69.0% had a revenue ranged between 0 and RWF 30,000. More than a half (60.4%) of respondents expressed they had not experienced CVDs in their families.

The knowledge was assessed using different parameters related to participants’ knowledge about CVDs, and findings are summarized in the following table 3 accordingly.

Findings in Table 2 show that 54.7% knew that smoking increases the risk of developing CVDs, 77.6% knew that consuming a lot of vegetables and fruits does not increase the risk of CVD, 76.3% knew that consuming too much salt is a risk to CVD, 77.3% knew that having excess body weight increases ones risk of CVD, 54.2% did not know that a family history of CVD increases ones risk of acquiring CVD, 55.5% knew that regular consumption of red meat is not healthier than white meat, 52.6% knew that cardiovascular diseases are curable upon completion of described dose, 62.0% refused that men are at higher risk of CVDs compared to women, 80.7% knew that excessive alcohol drinking is dangerous to cardiovascular health, 52.9% did not know that a person may know that he/she has CVD based on signs and symptoms alone, 78.1% refused that a person with CVD may infect a close person, 83.1% knew that high blood pressure is a risk factor of CVD, 64.3% knew that animal fat is not healthier than plant oil, 66.9% knew that old age is a risk factor for CVD, 78.6% knew that stress increases ones risk of getting CVD, 64.6% knew that exercising regularly is not harmful to cardiovascular health, 64.1% refused that high cholesterol in blood prevents one from CVD, more than a half (51.0%) of respondents did not know that CVD are not preventable, while 78.6% knew that doing health check-ups frequently is not harmful.

This part provides the general score on residents’ knowledge about CVDs, the following figure provides the actual data.

Nineteen (19) questions related to the knowledge towards CVDs were appraised by using SPSS score assessment and the score was one score for a correct answer and zero for false answer. An overall knowledge score was calculated by adding up the scores for each respondent across all 19 questions. Findings in Figure 1 specify that 76% of respondents had a high level of knowledge towards CVDs whereas 24% had shown a low level of knowledge towards CVDs. The mean knowledge score for all participants was found to be 14.2 (SD = 1.6). The minimum score was 9.9 scores and the maximum score was 19 scores.

In this study, attitude was assessed using different parameters, it includes five questions related to participants’ attitudes about CVDs, and the key findings on this aspect are summarized in the following table accordingly.

In this table, SD stands for Strongly Disagree, SA stands form Strongly Agree

Study results as presented in Table 4 reveal that 33.3% of respondents strongly agreed that everyone can get CVD, 35.7% agreed that if he/she had CVD, he/she would go for regular medical checkup, 26.3% agreed that if he/she had CVD, he/she would like to exercise more, 36.2% strongly agreed that if he/she had CVD, he/she would like to change their eating habits and 47.1% strongly agreed that if he/she had CVD, he/she would like to quit smoking.

This part provides the general score on residents’ knowledge about CVDs, the following figure provides the actual data.

The overall attitude score was calculated for each respondent by adding up the scores across the five (5) attitude-related questions. The true answer recorded 5 scores and the false answer got zero. The answers were ranged in the Likert scale format. From the findings presented in Figure 2, the researcher established that 296 (77.1%) of all respondents (384) had positive attitude towards CVDs while 88 (22.9%) showed negative attitudes towards CVDs. The mean attitude score for all respondents was 17.6 (SD = 5.7, minimum score = 5 and maximum score = 25).

This section contains different parameters, including five main questions and 3 sub-questions related to CVDs and were marked for each respondent accordingly.

Research findings presented in Table 4 revealed that 76.0% were not smoking but 55.4% of those who were smoking had tried to stop smoking, 62.2% of respondents were not consuming alcohol, 79.2% were using vegetable oil in cooking, 63.5% were practicing physical activity and exercise, where among those practicing physical activity and exercise 49.6% were doing it occasionally, and only 32.3% of respondents accepted they are doing regular CVDs’ checkup and 49.2% of them have been checked up hypertension followed by cardiomyopathies at 34.7%.

The practice’ section contained five questions related to CVDs and were marked for each respondent. If a respondent provided a correct response, he/she was given a score of 1 score. If he/she provided a false response, he/she was marked by zero.

An overall practices score was determined for each respondent by adding up the scores across the 5 main practice-related questions. The total score was 5 scores.

Research findings presented in Figure 3 revealed that 30% of all respondents had good practice while 70% presented poor practice towards CVDs. The mean practice score for all respondents was 3.9 (SD = 0.7). The minimum score was 2.5 scores and the maximum score was 5 scores.

The NCD epidemic continues to accelerate amongst the ongoing infectious diseases battle, health-care systems in the world are increasingly regarding CVDs in particular and NCDs in general as a top public health priority 21. To curb this distressing trend, health literacy has a prominent significance in prevention of CVD both at the primary and secondary levels 2223.

Defined health literacy as the individual s knowledge, motivation, and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life during the life course 24.

With a total 75.5% of participants having an overall adequate knowledge regarding to CVD risk factors, this present study demonstrated a highest level of health literacy in an urban setting of Rwanda. Our rates of CVD literacy echoes on the same level with findings of previous studies from South Africa 25, Iran 26 and Malaysia 27 which produced knowledge rates of 75.3, 78.7 and 81% respectively.

Contrary to these findings, regional studies from Nigeria with 44% 28 and 47.5% in Cameroon 29 revealed considerably low rates of CVD knowledge. This perceived variability in knowledge rates between cited studies could be explained by the education-level differences among study participants and diversity of tools used for knowledge assessment.

With regards to knowledge of specific risk behaviors, more than half of participants in this study acknowledged smoking (54.7%), having excess body weight (77.3%), excessive alcohol drinking (80.7%), consuming too much salt (76.3%), stress (78.6%) as CVDs risk factors, while having a family history of CVD was acknowledged by 45.8%. In other studies, a wide variation of knowledge rates regarding individual risk factors is observed in the literature. For instance, smoking has been recognized as a CVD risk by 36.2-93.2% of participants 252728, excess alcohol intake by 40.7% and 65% unhealthy diet by 2.8-88% 12 and excess body weight by 1.6-100% 30.

In contrast to our findings, a study conducted in Kuwait 31 recognized family history as an attributable risk of CVD. However, in a couple of other studies conducted in Cameroon 29, Turkey 32 majority (> 50%) of participants were unaware of the increased risk of acquiring CVD in the presence of a positive family history.

In this study, merely 35.7% had agreed that if they experienced a CVD, they would go for regular medical checkup. This was translated in the fact that only 32.3% of respondents accepted they are doing regular CVDs checkup. The study results show that the study participants had good attitude to CVDs (77.1%) even if simply 36.2% of participants had strongly agreed that if they had CVD, they would like to change their eating habits. This is in consistent with a study conducted Eastern Nepal, which reported that some of respondents revealed that if they had cardiovascular disease, they would: make regular checkups (92.7%), do more physical exercise (90.4%), change diet (93.9%), or stop smoking (90.6%) 33; and to another study conducted in Malaysia which reported that participants would make regular checkups (81%), eager to exercise more (94.9%), easily change their diet (70.1%) and quit smoking or become passive smoker (79.2%) if they were sick from CVD 34.

In contrast, a study conducted among migrant Chinese in Beijing found that negative attitudes on stop smoking were still high (56.1%) 34. Similarly, in a study done among French pregnant smokers also noted that 59.8% of them did not respond to the offer of cessation services 35.

The percentage of good practice in the present study was around 30.5% which indicates that the behaviour to reduce the CVD risk was non-promising and not optimal. It was consistent with the result found in a study conducted in low level of practice on keeping the normal weight between 28%-52% and nearly 59% in patients with CVD and the overall practice regarding CVD risk reduction behaviour were (50%) 36.

In the present study, some of practice items were reported as positive practice including not smoking (76.0%), trying to stop smoking (55.4%), not consuming alcohol (62.2%), using vegetable oil in cooking (79.2%), practicing physical activity and exercise (63.5%). These findings were consistent with what found North-East coast Malaysia 34, but inconsistent with another study conducted by Robinson and noted that the practice regarding maintaining the desired weight among CVD patients was lower between 27.6% and 52% as compared to our result 37. The comparison here may be biased since the interpretation of normal weight might differ as reported in other studies among British Bangladeshi women, 20% of them perceived that their weight were normal although in the actual fact, it was abnormal 38.