Early Cardiometabolic Dysregulation in Semi-Urban Nigerian Communities: A Focus on Prehypertension and Prediabetes

Background Hypertension and diabetes are major contributors to global cardiovascular morbidity and mortality. Early, subclinical disturbances such as prehypertension and prediabetes often precede overt disease, representing a critical window for prevention. In sub-Saharan Africa, rapid urbanization and lifestyle transitions have increased the prevalence of these early cardiometabolic abnormalities, yet data from semi-urban Nigerian populations remain limited. This study aimed to determine the prevalence and correlates of prehypertension, prediabetes, and their co-occurrence in adults from semi-urban Nigerian communities. Methods A cross-sectional study was conducted between 2019 and 2023 in Kogi State (Okene, Kabba, Lokoja) and Gwagwalada, FCT, Nigeria. Adults aged ≥ 18 years attending community health screenings were enrolled. Blood pressure, anthropometric measurements, and random blood glucose were collected using standardized protocols. Prehypertension was defined as systolic 120–139 mmHg or diastolic 80–89 mmHg; prediabetes as random blood glucose 7.8–11.0 mmol/L. Logistic regression models were used to identify predictors of these early cardiometabolic abnormalities. Results A total of 3,198 adults (76% women) were included, with mean age 44.7 ± 15.8 years. Prehypertension was observed in 83.2% of participants, prediabetes in 7.3%, and combined prehypertension with prediabetes in 6.3%. Prevalence increased with age across all categories. Men had higher odds of prehypertension (OR 1.38; 95% CI 1.08–1.78), but sex was not significantly associated with prediabetes or the combined phenotype. Waist circumference was significantly associated with prehypertension (OR 1.27; 95% CI 1.00–1.61), whereas body mass index showed only a borderline association. Age emerged as the strongest predictor for all outcomes, with adults aged ≥ 50 years exhibiting higher odds of prediabetes (OR 1.32), prehypertension (OR 1.70), and combined abnormalities (OR 1.41). Conclusion Early cardiometabolic abnormalities are highly prevalent in semi-urban Nigerian adults, particularly prehypertension. Age, male sex, and central obesity are key risk factors. These findings highlight the urgent need for targeted community-based screening, lifestyle interventions, and integrated non-communicable disease prevention strategies to mitigate the rising cardiovascular burden in African populations. Clinical trial number: not applicable.