Abstract Body: Introduction:
Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality globally, with a disproportionate burden in low- and middle-income countries. These settings often face a dual challenge of infectious and non-communicable diseases, hampering effective prevention and control efforts. The objective of this study was to assess the prevalence, awareness, treatment, and control of hypertension, and to examine its association with key clinical and demographic factors in a semi-urban community in Southern Nigeria.

Hypothesis:
We predicted that the prevalence of hypertension in the semi-urban community of Borokiri would be high, with many cases undiagnosed and poorly controlled. We also anticipated significant associations between elevated blood pressure and key demographic and clinical factors, including age, sex, obesity, and diabetes mellitus.

Methods:
We conducted a descriptive cross-sectional study among 2,154 consenting adults in Borokiri, a semi-urban riverine community in Southern Nigeria, over a two-week period in August 2024. Standardized procedures were used to collect data on blood pressure, anthropometric indices, and blood glucose. Hypertension was defined as systolic/diastolic BP ≥140/90 mmHg or current use of antihypertensive medication. Statistical analyses were performed using the SPSS statistical software, version 25.

Results:
The study population had a female preponderance (76.4%) with a mean age of 43.6 ± 15.4 years. Overall hypertension prevalence was 36.6% (n=788); of which nearly half (49.5%) of hypertensive individuals were previously undiagnosed and untreated. Among those on antihypertensive therapy (n=398), only 36.7% (n=146) achieved adequate blood pressure control (<140/90 mmHg). Multivariate analysis revealed that hypertension was significantly associated with older age (aOR: 6.3; 95% CI: 3.90–10.04), diabetes mellitus (aOR: 6.4; 95% CI: 3.71–11.13), male sex (aOR: 1.9; 95% CI: 1.26–2.80), family history of hypertension (aOR: 2.5; 95% CI: 1.66–3.65), and obesity (aOR: 1.8; 95% CI: 1.25–2.60).

Conclusion:
Hypertension in this semi-urban Nigerian community is highly prevalent, underdiagnosed, and poorly controlled. These findings highlights an urgent need for scalable, community-based interventions focused on population-wide screening, health education, lifestyle modification, treatment adherence support, and access to affordable antihypertensive medications particularly in resource-limited settings.