Malaysia is currently experiencing an epidemiologic and demographic transition. Rapid
urbanization and vast changes in lifestyles among the population has led to widespread
cardiovascular disease (CVD) outcomes. Also, until now, the most prevalent
cardiovascular risk factor has remained unknown among the Malaysian population. This
study aimed to identify the most significant cardiovascular risk factor among multiethnic
adults in Dengkil, Selangor. A case-control retrospective study comparing past exposure
(retrospective) between the case (total cholesterol (TC) ≥ 5.18 mmol/L) and control
groups (TC < 5.18 mmol/L) on CVD risk via guided questionnaire comprised of
International Physical Activity Questionnaire (IPAQ), Food Frequency Questionnaire
(FFQ), Depression, Anxiety and Stress Scales (DASS)-21 and SF-12 was carried out
among 180 respondents aged 20 to 56 years in Dengkil, Selangor. In the present study,
purposive and consecutive sampling were both applied to recruit respondents and also
considering ethnic as a factor; thus, quota sampling was also conducted. The data were
analyzed using Mann-Whitney, Kruskal-Wallis, Chi-Square, Independent Samples t-test
and multiple logistic regression tests. The findings indicated there were no significant
differences (p > 0.05) regarding all the risk factors between the case and control groups
except for personal medical history (p < 0.05). Chinese possessed the highest number of
significant risk and protective factors. Lastly, the quality of life of Malay controls was
higher than that of cases in terms of Physical Component Summary (PCS). Generally, all
the risk factors were independent in terms of total cholesterol status, except for personal
medical history. The significance of risk factors and protective factors varies according to
ethnicity.