OBJECTIVES: Life’s Simple 7 (LS7) is a metric developed by the American Heart Association for assessing ideal cardiovascular (CV) health. This study aimed to investigate the association between knowledge of CV risk factors and ideal CV health among Hong Kong adults. METHODS: We conducted a cross-sectional observational survey of adults (aged ≥18) in the community from July 2013 to March 2014. A structured questionnaire included demographic data, CV health promoting lifestyle behavior, known CV diseases and knowledge of CV risk factors. A CV risk knowledge score and overall LS7 score for each subject were calculated. Association of each LS7 component with its corresponding risk knowledge was explored. RESULTS:  Of 1,015 subjects surveyed, (mean age: 52.5±26.1; 29.2% male) only 0.5% had ideal CV health and 36.6% had 5 to 7 ideal CV health metrics. The proportion of subjects correctly identified all 7 CV risk factors was 38%. Elderly (≥65 years) subjects were less likely to identify high cholesterol (Odds Ratio (OR) 0.23; 95%CI: 0.07-0.73; P=0.01), high blood pressure (OR 0.08; 95%CI: 0.02-0.32; P<0.01), and high blood glucose (OR 0.35; 95%CI: 0.17-0.75; P=0.01) as CV risk factors. In logistics regression analysis, female (OR 1.53; 95%CI: 1.07-2.02; P=0.02), age<65 (OR 2.71; 95%CI: 1.36-5.39; P=0.01), and tertiary educational level or above (OR 2.71; 95%CI: 1.61-4.57; P<0.01) were positively associated with optimum LS7 score (≥10 out of 14 points). There was no association between subject’s CV health seeking lifestyle behavior and recognition of corresponding CV risk factor. CONCLUSIONS: Less than 1% of adults had ideal CV health in Hong Kong. Knowledge of CV risk factors and history of CV disease were not associated with better CV health or lifestyle behavior. This suggested that education alone may not be sufficient to promote better CV health.