Hypertension and obstructive sleep apnea among adults with overweight or obesity in Tiko Health District, Cameroon: a community-based cross-sectional study

Abstract Background Hypertension, excess adiposity, and obstructive sleep apnea (OSA) frequently coexist and contribute to cardiovascular risk, yet community-based data on their combined burden in Cameroon remain scarce. The study assessed the prevalence of hypertension, adiposity, and OSA risk among adults in the Tiko Health District, Cameroon. Methods This community-based cross-sectional study included adults aged ≥ 18 years who attended a one-week health screening campaign in four health areas of the Tiko Health District, Cameroon, in August 2026. Anthropometric measures, cardiovascular risk factors, blood pressure, and sleep-related symptoms were assessed using standardized procedures. Body mass index (BMI) was categorized according to WHO criteria. Blood pressure was defined as the mean of two seated measurements, and hypertension was defined as a measured blood pressure ≥ 140/90 mmHg or current antihypertensive treatment. OSA risk was assessed with the STOP-BANG questionnaire, and excessive daytime sleepiness with the Epworth Sleepiness Scale (ESS). Associations between adiposity and hypertension were evaluated using modified Poisson regression with robust variance to estimate adjusted prevalence ratios (aPRs). Statistical significance was set at P < 0.05. Results Of 304 participants, 221 (72.7%) were female, and the mean age was 43.4 ± 16.2 years. BMI was available for 302 participants; 95/302 (31.5%) were overweight, and 120/302 (39.7%) had obesity. Hypertension was present in 110/304 participants (36.2%, 95% CI 31.0–41.7). Among participants with hypertension, 48/110 (43.6%) were aware, 29/110 (26.4%) were receiving treatment, and 11/110 (10.0%) were controlled. A positive STOP-BANG screen occurred in 115/299 participants (38.5%, 95% CI 33.1–44.1), and ESS > 10 was present in 46/304 (15.1%). After adjustment for age, sex, residence, and diabetes, hypertension prevalence did not differ markedly between overweight (aPR 0.90, 95% CI 0.60–1.33) and obesity (aPR 1.27, 95% CI 0.90–1.79) and BMI < 25 kg/m². Each 5-kg/m² higher BMI was associated with a 13% higher prevalence of hypertension (aPR 1.13, 95% CI 1.03–1.24). Greater waist circumference (aPR 1.10 per 10 cm, 95% CI 1.02–1.20) and waist-to-height ratio (aPR 1.24 per 0.1 unit, 95% CI 1.13–1.37) were similarly associated with hypertension. Obesity was also associated with higher mean systolic blood pressure (β 9.5 mmHg, 95% CI 4.0–15.1) and diastolic blood pressure (β 7.8 mmHg, 95% CI 4.3–11.3) compared with BMI < 25 kg/m². Conclusions Among adults attending community screening, excess adiposity, hypertension, previously undetected high blood pressure, and elevated OSA risk were common. The accompanying gaps in hypertension awareness, treatment, and control underscore the need for community-based detection, confirmatory blood-pressure assessment, cardiovascular risk reduction, and referral for objective sleep evaluation.