Awareness and Self-Reported Application of the “10 Golden Rules” for Cardiovascular Prevention among Amateur Weekend Athletes in Douala, Cameroon: A Cross-Sectional Study

Background: The “10 Golden Rules” provide evidence-based guidance to reduce cardiovascular risk during recreational sport, but their awareness and application in sub-Saharan African settings remain largely unknown. This study assessed awareness and self-reported application of these rules among amateur recreational athletes in Douala, Cameroon. Methods: A cross-sectional survey was conducted from September 2025 to January 2026 in two major sports centres in Douala. We enrolled adults (≥18 years) who self-reported regular recreational physical activity at least once every two weeks, primarily on weekends (operational definition of “weekend athlete”), excluding professional or competitive athletes. Data collection included standardized anthropometric and blood pressure measurements, plus interviewer-administered questionnaires assessing awareness (“already heard of”: yes/no) and self-reported application frequency (“never”/”sometimes”/“often”/”always”/”not applicable” if the situation never occurred) of each rule. Results: Participants (median age 43 years; 54.5% women) were highly educated (69.1% university level) but exhibited a substantial cardiometabolic burden: median BMI 28.7 kg/m² (49.1% overweight, 36.4% obese), 79.1% with abdominal obesity, and 26.4% with diastolic hypertension. Awareness exceeded 70% for five rules: warm-up/recovery (89.1%), avoidance of smoking (70.9%) and illicit drug consumption (76.4%), and symptom consultation (73.6%). Application was low overall. Among participants to whom symptom-related rules applied (i.e., excluding “not applicable” responses), “never” applying remained high (e.g., 46.4% for chest pain consultation overall; restricted estimates similar or higher). “Never” applying was reported by 46.4% for chest pain consultation, 50.9% for palpitations, 50.9% for malaise, and 64.6% for age-based pre-participation medical screening. Awareness was lowest for hydration every 30 minutes (22.7%) and the age-based medical check (Rule 10, 45.5%). Exploratory stratification showed numerically lower awareness of Rule 10 among women (41.7%) than men (50.0%), with particularly low levels in the groups to whom the rule directly applies: 48.7% among men ≥ 35 years and only 25.9% among women ≥ 45 years. Only 13.6% reported knowing how to perform chest-compression CPR. Conclusion: In this urban Cameroonian sample of recreational athletes, a