Prevalence of hypertension among adults in Nigeria: a systematic review and meta-analysis

Hypertension is a leading contributor to cardiovascular morbidity and mortality and a major driver of the noncommunicable disease burden in low- and middle-income countries. In Nigeria, prevalence estimates vary widely due to methodological heterogeneity across studies. We conducted a systematic review and meta-analysis to generate a current and geographically representative pooled estimate of hypertension prevalence among Nigerian adults. To estimate pooled prevalence of hypertension in Nigeria and examine subgroup differences. We conducted a systematic review and meta-analysis of primarily cross-sectional studies to estimate the pooled prevalence of hypertension and examine subgroup differences (sex, settings, and geopolitical zones). Eligible studies were identified through comprehensive database searches and screened according to predefined inclusion criteria. Pooled estimates were calculated using a random-effects model to account for between-study variability. Seven databases (MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, PsychInfo, and African Journals Online) were systematically searched for primary studies published from January 2015 to September 2025. Eligible studies measured hypertension among adult Nigerians 18 years and above as systolic blood pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg or on antihypertensive medication). Titles and abstracts were screened, data were extracted, and the quality of studies evaluated by two independent reviewers using the Newcastle-Ottawa Scale. Heterogeneity was assessed through Q-test, I2, tau2, and 95% prediction interval. Sensitivity analyses according to the potential sources of heterogeneity across the included studies were conducted. Thirty-two studies comprising 49,788 participants were included. The pooled prevalence of hypertension was 34.2% (95% CI: 29.6, 39.1%), with substantial heterogeneity (I² = 99.1%; τ² = 0.367; 95% PI: 13–65%). Prevalence did not differ significantly between rural (34.4%) and urban (34.0%) settings (p = 0.175), males (41.6%) and females (32.3%) (p = 0.106), or across geopolitical zones (p = 0.148), although the South-West (41.7%) and North-Central (38.1%) regions showed higher point estimates. Hypertension affects approximately one in three Nigerian adults, indicating a substantial and widespread burden with regional variation but limited rural–urban or sex differences. These findings underscore the importance of sustained surveillance and context-specific strategies to address hypertension in Nigeria.