Cross-Sectional Associations of Dietary Pattern, Physical Activity with Hypertension Among Adults in Southwestern Nigeria

Background: Hypertension and unhealthy traditional diets often coexist among Nigerian adults, but limited regional evidence clarifies how local dietary patterns correlate with hypertension prevalence, leading to fragmented, culturally insensitive prevention guidelines. Objectives: This cross-sectional analysis examined cross-sectional associations between PCA-derived dietary patterns and physical activity levels and hypertension prevalence among adults residing in Oyo and Kwara States, southwestern Nigeria. Methods: A total of 608 eligible adults completed a culturally validated 7-day Food Frequency Questionnaire (FFQ) and Global Physical Activity Questionnaire (GPAQ). Standardized single-visit blood pressure measurements defined hypertension per WHO criteria. Robust cluster-adjusted Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI, all two-sided p < 0.05). Results: The overall prevalence of hypertension was 24.34%, with significantly higher prevalence among males (29.78%) compared to females (16.67%). Four distinct dietary patterns were extracted via Varimax-rotated PCA: diversified traditional pattern, typical traditional pattern, fruits and vegetables pattern, and fats and soft drinks pattern. After full covariate adjustment, highest adherence to the typical traditional pattern was significantly associated with higher hypertension prevalence (PR = 1.642, 95% CI: 1.069–2.252, p = 0.024). In contrast, maximum adherence to the fruit and vegetable pattern was associated with lower hypertension prevalence (PR = 0.408, 95% CI: 0.258–0.646, p < 0.001). No significant cross-sectional associations were detected for diversified traditional or fats and soft drinks patterns. The crude positive activity–hypertension association turned non-significant after adjusting for all dietary patterns. Conclusions: Distinct local dietary patterns displayed consistent cross-sectional associations with hypertension prevalence in this population, while physical activity showed no independent correlation with hypertension after accounting for habitual diet.