Cardiometabolic Risk Factors Among Adults in a Rural Amazonian Peruvian Population

<i>Background and Objectives</i>: Cardiometabolic diseases are rising in Latin America, yet rural Amazonian populations remain understudied. We aimed to characterize the prevalence and factors associated with a simple composite cardiometabolic risk in rural Amazonian adults. <i>Materials and Methods</i>: We conducted an analytical cross-sectional study during community screenings in San Martín, Peru, in 2025, enrolling adults aged ≥ 18 years. The outcome was present when ≥2 biological/anthropometric alterations were identified at the same visit (hypertension, dyslipidemia, hyperglycemia, hyperuricemia, general obesity, abdominal obesity, or elevated waist-to-hip ratio). Behaviors included current tobacco use, alcohol risk (AUDIT), and physical activity (IPAQ). We summarized variables (univariate), compared groups (bivariate: chi-square; Fisher for alcohol), and fitted modified Poisson regression with robust errors to estimate prevalence ratios (PRs); variables with <i>p</i> ≤ 0.20 in bivariate analysis entered multivariable models. <i>Results:</i> We enrolled 205 adults; 70.2% met the composite outcome. In multivariable models, abdominal obesity (adjusted PR [aPR] 1.70; 95% CI 1.40-2.10), hyperglycemia (1.65; 1.25-2.17), hyperuricemia (1.38; 1.19-1.61), dyslipidemia (1.25; 1.07-1.46), and general obesity (1.21; 1.04-1.40) were independently associated with cardiometabolic risk. Hypertension (1.06; 0.88-1.29) and elevated waist-to-hip ratio (1.20; 0.88-1.63) were not. Physical activity differed crudely but showed no independent association; tobacco and alcohol were not associated. <i>Conclusions:</i> In this rural Amazonian population, we observed a high prevalence of composite cardiometabolic risk and found that central adiposity and metabolic derangements, not blood pressure or self-reported behaviors, were the main correlates. Simple measures such as waist circumference, fasting glucose or HbA1c, a basic lipid panel, and serum urate may help flag adults at higher cardiometabolic risk in similar low-resource primary-care settings, but prospective studies are needed to evaluate their predictive value and screening performance.