Cardiovascular diseases (CVDs) are responsible for many deaths around the world. Risk factors for these diseases include co-morbidities such as high blood pressure (HBP), diabetes mellitus (DM) and dyslipidemia (DLP). These risk factors should be properly diagnosed so as to prevent and control the complications like stroke, Myocardial infarction and peripheral vascular disease. Proper medication management and patient compliance are important for preventing and treating these diseases. Thereby improving patient’s overall health and quality of life. The need for clinical pharmacist is increasing in the health care system for educating patient. about their diseases and its management by improving patient compliance The Objectives were to analyze the prevalence of DM, HTN, and DLP in patients with Acute Stroke, MI and/or Peripheral vascular disease, to assess gender and age distribution of cardiovascular risk factors and events, to evaluate the cardiovascular risks in different age categories of male and female patients respectively and to study the effect of clinical pharmacist initiated patient tele counseling on medication adherence and knowledge of the patients. The study was conducted at a tertiary care Hospital, located at Kerala ,India. For a period of six month from November 2020 to May 2021, by taking retrospective data of five year period (2016 - 2020).The demographic details, laboratory details and treatment details were collected from the hospital files and recorded in predefined patient profile form.The prevalence of DM, HTN, and DLP in cardiac patients (with acute stroke / MI / peripheral vascular disease) was evaluated in the study. The study also assessed the age-category and the gender-group more susceptible in showing high incidence rates of DM / HTN / DLP or a comorbidity of the three. Assessment of patient’s knowledge concerning their disease condition and proper medication use, via tele – counselling was also focused in the study aiming at imparting patient – level education and improving post – level medication adherence.Patient tele counselling including additional information on disease, risk factors, dietary modification, importance of medication adherence and side effects of medicines to be looked out for were provided.Using prospective data, the knowledge of patients on the three domains namely knowledge, attitude and practice was assessed using specially pre designed and validated Knowledge Attitude Practice (KAP) questionnaires. The baseline scores for the questionnaires were obtained from all the patients via tele communication and the final score were obtained using the same questionnaire.From the study, it was understood that HTN, DM were the most common cardiovascular risk factor in stroke, PVD and MI .The risk factors were mostly seen in males. In people of age category below 65 HTN, DM, DLP were more prevalent. In people of age category above 65 years the most common CV risk factors were HTN and DM. Through tele - counselling , the patients knowledge, attitude, practice and adherence were assessed and improved.The study also emphasized the role of clinical pharmacist in educating and improving the patient compliance thereby improving quality of life.