Prevalence of obesity among adults with arterial hypertension in Cameroon: a systematic review and meta-analysis

Hypertension and obesity are major and growing public health concerns in sub-Saharan Africa, driven by lifestyle and nutritional transitions. However, evidence on the burden of obesity among hypertensive patients in Cameroon remains limited. This systematic review and meta-analysis aimed to determine the pooled prevalence of obesity and overweight among adults living with arterial hypertension in Cameroon. Following PRISMA guidelines, we searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, African Journals Online, Health Sciences and Diseases, and Google Scholar. Studies reporting overweight, obesity, or abdominal obesity prevalence among adults with hypertension in Cameroon were included. Random-effects meta-analyses were performed, and heterogeneity, publication bias, and sensitivity analyses were assessed. Fifteen studies comprising 6,600 adults with arterial hypertension were included. The pooled prevalence of obesity was 32.7% (95% CI 26.2–40.0, I 2 = 93.1%). Overweight prevalence was 35.4% (95% CI 32.2–38.7, I 2 = 85.3%), and abdominal obesity prevalence was 51.3% (95% CI 41.2–61.2, I 2 = 90.1%). Subgroup analyses showed significant differences according to region. Obesity prevalence ranged from 24.7% (95% CI 12.1–43.7; 4 studies; n = 1,213) in the West region to 38.1% (95% CI 33.4–42.9; 3 studies; n = 846) in the South-West region ( p < 0.001). By geographic area, obesity prevalence was highest in mixed urban–rural settings (41.7%; 95% CI 40.1–43.4; 2 studies; n = 3,271), and lower in urban settings (30.2%; 95% CI 22.1–39.9; 9 studies; n = 2,341) ( p = 0.039). According to study period, obesity prevalence was 33.4% (95% CI 30.7–36.1; 4 studies; n = 1,196) before COVID-19, 30.7% (95% CI 16.9–48.9; 5 studies; n = 4,131) during COVID-19, and 35.3% (95% CI 27.7–43.7; 4 studies; n = 1,096) after COVID-19, with no significant difference ( p = 0.852). Estimates based on few studies were considered exploratory and interpreted cautiously. Excess adiposity is highly prevalent among adults with arterial hypertension in Cameroon, with approximately one-third obese, more than one-third overweight, and over half presenting abdominal obesity. These findings highlight the need to integrate routine BMI and waist circumference assessment into hypertension care and to strengthen targeted lifestyle interventions to reduce cardiometabolic risk. Systematic review registration number: CRD420261370662.