Prehypertension and prediabetes in Rwandan adults aged 18–69 years: insights from the 2022 STEPwise survey

Background Prediabetes (PreDM) and prehypertension (PreHTN) are important opportunities for prevention strategies to reduce the risk of diabetes and hypertension. However, population-level data remain scarce, especially in low-income settings. Using data from the 2022 Rwanda STEPwise survey, we describe the epidemiology of PreDM and PreHTN among adults aged 18–69 years. Methods PreDM and PreHTN status were defined according to the World Health Organization and Rwanda 2024 NCD management guidelines, respectively. Bivariate and multivariate analyses were used to determine independent factors of PreDM and PreHTN. Results The study included 61.4% (n = 3388) females and had a median (± interquartile range) age of 39 (±19) years. The overall prevalence of PreDM was 4.5% [95% confidence interval (CI): 3.7–5.3]; the prevalence of PreHTN was 22.1% (95% CI: 20.7–23.4). The prevalence of overt diabetes and hypertension was 3.0% (95% CI: 2.1–3.8) and 16.9% (95% CI: 15.7–18.1), respectively. Education (P = .011), residence (P = .003), central-waist obesity (P = .029), and cholesterol levels (P = .020) were significantly associated with PreDM. Residence (P = .036), wealth status (P = .023), alcohol consumption (P < .001), and fruit and vegetable intake (P = .039) were associated with PreHTN. Conclusion The prevalence of PreHTN is relatively high, whereas that of PreDM is moderately low. The prevalence of PreHTN was roughly one and a third times that of hypertension and that for prediabetes was about one and a half times that of diabetes. These results provide a basis for early detection and intervention during this critical clinical stage to prevent future burdens of diabetes and hypertension in Rwanda. Rwanda can leverage its functional community health-worker network to enhance screenings and provide community-based basic lifestyle counselling for those at risk of PreDM and PreHTN.