Hypertension among flour mill workers in Goma, Democratic Republic of the Congo: cross-sectional analysis of occupational, lifestyle, and sociodemographic associated factors

Hypertension is a major risk factor for cardiovascular disease, yet data on occupational determinants among flour mill workers are limited. This study aimed to assess the prevalence of hypertension and identify associated socio–demographic, lifestyle, and occupational factors associated with hypertension among flour mill workers in Goma, Democratic Republic of the Congo. A cross-sectional study was conducted among 392 flour mill workers. Data on socio–demographic characteristics, lifestyle behaviours, occupational exposures, and psychosocial factors were collected using a standardised questionnaire and physical examination. Occupational noise exposure was objectively measured using a dosimeter. Blood pressure was measured following standardised procedures, and hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg based on three consecutive BP readings obtained at intervals of at least five minutes, or reported use of antihypertensive medication. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors independently associated with hypertension. Model diagnostics included variance inflation factor (VIF), Hosmer–Lemeshow goodness-of-fit, and area under the ROC curve (AUC). Of the 392 participants, 34.9% (95% CI: 30.40%–39.79%) were hypertensive. In multivariable analysis, factors independently associated with hypertension included being married (AOR = 3.03; 95% CI: 1.43–6.41), family history of hypertension (AOR = 2.55; 95% CI: 1.43–4.52), higher education (secondary/university) (AOR = 2.54; 95% CI: 1.29–4.97), adding salt at the table (AOR = 2.08; 95% CI: 1.22–3.55), alcohol consumption (AOR = 2.48; 95% CI: 1.45–4.24), occupational noise exposure ≥ 80 dBA (AOR = 2.72; 95% CI: 1.33–5.59), tobacco use (AOR = 1.78; 95% CI: 1.00–3.20), and perceived stress (AOR = 2.62; 95% CI: 1.51–4.52). The final model showed no multicollinearity (mean VIF = 1.29), good fit (Hosmer–Lemeshow p = 0.953), and high discriminative ability (AUC = 0.837). Hypertension is highly prevalent among flour mill workers, with lifestyle, psychosocial, and occupational factors being associated with hypertension prevalence. Interventions targeting salt intake, alcohol use, tobacco cessation, stress management, and noise exposure reduction may inform hypertension prevention strategies in this occupational group.