Socio-demographic, lifestyle, and anthropometric predictors of ambulatory blood pressure among adults in semi-urban Nigeria

Ambulatory blood pressure monitoring (ABPM) offers greater predictive capability for cardiovascular outcomes than clinic blood pressure measurement. However, the factors influencing ambulatory hypertension in African populations continue to be insufficiently researched. To identify the socio-demographic, lifestyle, and anthropometric factors that predict 24-hour, daytime, and nighttime ambulatory blood pressure levels among adults in a semi-urban Nigerian community. A community-based cross-sectional study was conducted among 348 adults who underwent 24-hour ABPM, along with a structured assessment of socio-demographic, behavioural, and anthropometric factors. Associations were evaluated using bivariate, multivariate linear regression and logistic regression analyses. Age, higher body mass index (BMI), lower income, and lower educational level were consistently associated with elevated blood pressure (BP) over 24 h, during daytime, and nocturnally. Frequent salt consumption was significantly correlated with abnormal BP across all time periods. Linear regression analysis identified education (β = − 0.24; p = .007), BMI (β = 0.35; p = .012), and age (β = 0.47; p = .029) as independent predictors of 24-hour systolic blood pressure. Logistic regression models for abnormal 24-hour, daytime, and nocturnal hypertension (Nagelkerke R² = 0.51–0.62; accuracy 75–86%) demonstrated strong effects of age, obesity, income, physical activity, and salt intake. Ambulatory blood pressure patterns in this population are significantly influenced by factors such as age, adiposity, educational attainment, income, and dietary salt intake. These findings highlight critical targets for population-level hypertension prevention strategies, including reducing obesity, regulating salt intake, and enhancing socioeconomic health literacy.