Socioeconomic, Lifestyle, and Dietary Factors Associated with Concurrent Hypertension and Diabetes among Adults in Selected Communities in Southwestern Nigeria: A Cross- Sectional Study

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Concurrent hypertension and diabetes mellitus (n=244). Intervention: Higher monthly income (per income-category increase) vs. Lower monthly income category. Primary outcome: Concurrent hypertension and diabetes screening positivity (aOR 1.45, 95% CI 1.05-1.98, p=0.023 (FDR q=0.251)).

Q: What does this research mean for the field?

Higher monthly income is positively associated with concurrent hypertension and diabetes screening positivity in adults in Southwestern Nigeria, although this relationship does not withstand correction for multiple testing. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Adeyemi-Benson; Oluwateniola Ajoke Adeyemi-Benson; Peter Olaniyi; Anifat Opeyemi Oladele; Folajimi T. Jolayemi

doi:10.21203/rs.3.rs-11079196/v1

October 22, 2026Open Access

Socioeconomic, Lifestyle, and Dietary Factors Associated with Concurrent Hypertension and Diabetes among Adults in Selected Communities in Southwestern Nigeria: A Cross- Sectional Study

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Key result

Higher monthly income links to ~45% higher odds of concurrent hypertension and diabetes screening positivity.

aOR 1.45
95% CI 1.05-1.98
P=0.023 (FDR q=0.251)
n=244

Why the study?

Hypertension and diabetes frequently coexist and increase cardiometabolic morbidity and mortality, but evidence on their coexistence and socioeconomic, lifestyle, and dietary correlates in Southwestern Nigeria remains limited.

Key Points

To evaluate the burden of concurrent hypertension and diabetes and identify associated socioeconomic, lifestyle, and dietary factors among adults in Southwestern Nigeria.
A community-based cross-sectional study using two-stage probability sampling screened 500 adults in urban and peri-urban Southwestern Nigeria between July and December 2025.
A cohort of 244 participants who screened positive for at least one condition underwent dietary, anthropometric, and sociodemographic assessments, with dietary patterns derived via principal component analysis.
Associations with concurrent screening positivity were analyzed using Firth bias-reduced logistic regression adjusted for age, sex, and body mass index, applying Benjamini-Hochberg false-discovery-rate correction across 11 exposure tests.
Concurrent hypertension and diabetes was identified in 36 of 500 screened adults (7.2%; 95% CI 5.2%–9.8%) overall and in 36 of 244 screen-positive adults (14.8%; 95% CI 10.9%–19.7%).
Higher monthly income showed an adjusted positive association with concurrent screening positivity (aOR per income-category increase 1.45, 95% CI 1.05–1.98; p = 0.023), but did not remain statistically significant following false-discovery-rate correction (q = 0.251).
None of the evaluated lifestyle indicators or three identified dietary patterns (plant-rich traditional, beverage-animal foods, grain-condiment/snack) remained significantly associated with concurrent screening positivity after multiple-testing correction.

Study Design

Type

Cross-Sectional (n=244)

Multicenter

Yes

Structured PICO

P

Population

244 community-dwelling adults in Southwestern Nigeria (mean age 55.5 years, 78.7% female) who screened positive for hypertension and/or diabetes out of 500 randomly selected adults, excluding pregnant, critically ill, or therapeutic-diet individuals.

E

Exposure

Socioeconomic, lifestyle, and dietary exposures: monthly income (<₦50,000; ₦50,000-100,000; ₦100,000-200,000; >₦200,000), smoking status, household exposure to a smoker, current alcohol or alcohol-containing herbal-mixture use, regular physical activity frequency, meal skipping, adding salt at the table, checking nutrition labels, and three PCA-derived dietary patterns (plant-rich traditional, beverage-animal foods, and grain-condiment/snack).

O

Outcome

Concurrent hypertension and diabetes screening positivity (defined as meeting screening criteria for both hypertension [previous clinical diagnosis or study SBP ≥140 mmHg and/or DBP ≥90 mmHg] and diabetes [previous clinical diagnosis or random capillary blood glucose ≥11.1 mmol/L]) versus screening positive for only one condition in the 244-person analytic cohort, and overall prevalence among all 500 screened adults.surrogate

Main Result

Odds Ratio: 1.45 (95% CI 1.05–1.98)

p-value: p=0.023 (FDR q=0.251)

Limitations

Cross-sectional design using single-visit screening measurements (BP and random capillary glucose) rather than confirmatory clinical diagnosis
Limited number of concurrent outcome events (n=36), rendering association analyses exploratory and losing statistical significance after multiple-testing correction
Community identifiers and selection probabilities were not retained in the final analytic dataset, preventing adjustment for community clustering and sampling weights
Fish and meat food-frequency variables had identical archived responses for all participants and could not be distinguished
Physical activity assessment lacked sufficient duration and intensity details to determine if guideline targets were met
Cross-sectional design and single-visit screening measurements preclude causal inference or assessment of incident disease
Limited number of concurrent outcome events (36 participants) rendered association analyses exploratory
Community identifiers, frame sizes, contact/nonresponse logs, and selection probabilities were not retained in the final analytic dataset, preventing weighting or clustering correction for standard errors
Questionnaire did not capture sufficient physical activity duration and intensity to determine whether guideline targets were met
Fish and meat food-frequency responses were identical in the archived dataset and could not be distinguished

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Implication

Concurrent hypertension and diabetes affects 7.2% of screened community adults (14.8% of those screening positive for either condition) in Southwestern Nigeria, with a positive exploratory association with higher income that did not survive multiple-testing correction, highlighting the need for integrated community screening.

Abstract

Background Hypertension and diabetes frequently coexist, increasing cardiometabolic morbidity and mortality. Evidence on the coexistence of these conditions and their socioeconomic, lifestyle, and dietary correlates in Southwestern Nigeria remains limited. This study aimed to assess the burden of concurrent hypertension and diabetes and determine the socioeconomic, lifestyle, and dietary factors associated with their coexistence among adults in selected communities in Southwestern Nigeria. Methods A community-based cross-sectional study was conducted among adults in selected urban and peri-urban communities in Southwestern Nigeria between July and December 2025. Using a two-stage probability-sampling approach, 500 adults were screened for hypertension and diabetes. All 244 participants who screened positive for at least one condition underwent detailed sociodemographic, lifestyle, anthropometric, and dietary assessment. Dietary patterns were derived using principal component analysis. Associations with concurrent hypertension-diabetes screening positivity were evaluated using Firth bias-reduced logistic regression adjusted for age, sex, and body mass index, with Benjamini-Hochberg false-discovery-rate correction across 11 exposure tests. Results Among the 244 screen-positive participants, 14.8% had both conditions. Three dietary patterns, plant-rich traditional, beverage-animal foods, and grain-condiment/snack, explained 39.0% of dietary variation. Higher monthly income showed the strongest adjusted association with concurrent screening positivity (aOR per income-category increase 1.45, 95% CI 1.05–1.98; p = 0.023), but this association did not remain statistically significant after false-discovery-rate correction (q = 0.251). No measured lifestyle or dietary-pattern exposure remained significant after correction. Sensitivity analyses using more specific outcome definitions showed a similar positive income gradient. Conclusion Concurrent hypertension and diabetes represents a meaningful cardiometabolic burden among adults in these Southwestern Nigerian communities. Although higher income showed a consistent positive association across analyses, the finding remains exploratory because it did not withstand multiple-testing correction. Integrated screening and larger prospective studies using confirmatory measurements are warranted.

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Cite This Study

Adeyemi-Benson et al. (2026) conducted a cross-sectional in Concurrent hypertension and diabetes mellitus (n=244). Higher monthly income (per income-category increase) vs. Lower monthly income category was evaluated on Concurrent hypertension and diabetes screening positivity (aOR 1.45, 95% CI 1.05-1.98, p=0.023 (FDR q=0.251)). Higher monthly income was associated with concurrent hypertension-diabetes screening positivity (aOR 1.45, 95% CI 1.05–1.98; p=0.023), but did not remain significant after FDR correction (q=0.251).

synapsesocial.com/papers/6ae28f3bcbadf70daf6c4437 https://doi.org/10.21203/rs.3.rs-11079196/v1

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Socioeconomic, Lifestyle, and Dietary Factors Associated with Concurrent Hypertension and Diabetes among Adults in Selected Communities in Southwestern Nigeria: A Cross- Sectional Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Socioeconomic, Lifestyle, and Dietary Factors Associated with Concurrent Hypertension and Diabetes among Adults in Selected Communities in Southwestern Nigeria: A Cross- Sectional Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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