Prevalence and Determinants of Pre-Hypertension among Adults in Fujian Province, China: A Large-Scale Cross-Sectional Study

Background: Prehypertension is a critical precursor to cardiovascular diseases, posing a significant public health burden. This study investigated its prevalence, determinants, and predictive modeling among adults in Fujian Province, China. Methods: A population-based cross-sectional survey was conducted from August 2020 to April 2021. Using multi-stage stratified random sampling, 9455 adults (≥18 years) were recruited. Prehypertension was defined according to JNC 7 guidelines (SBP 120–139 and/or DBP 80–89 mmHg) without antihypertensive medication. Determinants were identified via multivariable logistic regression, and a nomogram was developed and validated. Univariate analysis identified smoking and alcohol consumption as potential correlates, while multivariate analysis was used to determine independent predictors. Results: The weighted prevalence of prehypertension was 37.35%. Independent risk factors included older age, rural residence, central obesity, family history of hypertension, dyslipidemia, tea consumption, and elevated triglyceride-glucose (TyG) index. Notably, smoking was associated with a lower odds ratio in the multivariate model (OR = 0.737), a finding likely attributable to residual confounding or reverse causality rather than a true protective effect. The nomogram demonstrated robust predictive performance (AUC: 0.755 in training; 0.746 in validation). Conclusion: Prehypertension is highly prevalent among adults in Fujian Province. The identified risk factors and validated nomogram provide a scientific foundation for precise primary prevention and early intervention strategies.