Prevalence and clustering of major cardiovascular risk factors among community-dwelling older adults in rural Enugu State, Nigeria: a cross-sectional study

Background Cardiovascular disease and stroke remain leading causes of morbidity and mortality globally, with a disproportionate burden in low- and middle-income countries. Older adults in rural Nigerian communities may experience substantial cardiometabolic risk, yet locally specific epidemiological data remain limited. This study estimated the prevalence, clustering, and demographic correlates of major cardiovascular risk factors among community-dwelling older adults in Abor, Enugu State, Nigeria. Methods A community-based cross-sectional study was conducted among 107 adults aged ≥ 60 years. Sociodemographic and clinical data were collected using standardized procedures. Blood pressure and anthropometric indices were measured, and biochemical assays were performed for glycaemic and lipid indices. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Overweight/obesity was defined as BMI ≥ 25 kg/m². Diabetes was defined biochemically as fasting blood glucose (FBS) ≥ 126 mg/dL and/or HbA1c ≥ 6.5%, with prevalence calculated among participants for whom at least one glycaemic measure was available. Dyslipidaemia was defined as the presence of ≥ 1 abnormal lipid criterion. Prevalence estimates were reported with Wilson 95% confidence intervals (CIs), and prevalence ratios (PRs) were estimated using modified Poisson regression with robust variance. Results Of 107 participants, 57 (53.3%) were men and 50 (46.7%) were women; mean age was 70.9 ± 5.8 years. Among the 100 participants with recorded age. Hypertension prevalence was 58.9% (63/107; 95% CI 49.4–67.7), overweight/obesity was 69.2% (74/107; 95% CI 59.9–77.1), and diabetes was 67.0% (71/106; 95% CI 57.6–75.2). Any dyslipidaemia affected 72.0% (77/107; 95% CI 62.8–79.6), driven largely by low HDL-C (51.4%). Notably, despite the high prevalence of BMI-defined overweight/obesity, no participant met conventional waist-circumference criteria for central obesity. Cardiometabolic risk-factor clustering (≥ 2 of hypertension, overweight/obesity, and diabetes) occurred in approximately seven in ten participants. After age adjustment, women had a higher prevalence of dyslipidaemia than men (PR 1.47; 95% CI 1.14–1.90; p = 0.003). No statistically significant age associations were detected for the other major outcomes, although age-stratified estimates were imprecise, particularly among participants aged ≥ 80 years. Conclusion Older adults in this rural Nigerian community carried a substantial and frequently clustered cardiometabolic risk burden. The discordance between high BMI-defined overweight/obesity and absent waist-defined central obesity warrants further evaluation of the performance of conventional anthropometric thresholds in older African populations. These findings support integrated, multi-risk-factor cardiovascular screening and prevention within rural primary and community healthcare systems.