OBJECTIVE Hypertension has become a major health burden in sub-Saharan Africa, mainly due to urbanization and Western acculturation. We investigated the prevalence of hypertension and risk factors in a rural community in South-South Nigeria. METHODS Blood pressure and anthropometric indices were measured during a cross-sectional study of community health status among 1078 adults, aged > or = 18 years, in 2008. Information on lifestyle was also collected through structured interviews. METHODS Unadjusted hypertension prevalence was calculated against selected risk factors, and association was demonstrated using risk ratios with 95% confidence intervals. Chi-square was used to test for statistical significance at P < .05. Adjusted analysis was done for age by direct standardization using a reference population. METHODS Prevalence of hypertension, defined as systolic and diastolic blood pressure > or = 140 mm Hg and > or = 90 mm Hg respectively and/or current use of antihypertensive medication. RESULTS Crude prevalence of hypertension was 18.3% (95% CI = 16.0-20.7), while the age-adjusted prevalence was 2.63% (95% Cl = 2.59-2.66). Hypertension rate increased with age (RRs > 2.0, P = .00) and was higher in those married (RR = .35, P = .00), but showed no sex difference (RR = 1.13, P = .34). Hypertension was associated with tobacco chewing/ snuffing (RR = 2.32, P = .05) and history of diabetes (RR = 3.36, P = .00); but central obesity, alcohol intake, cigarette smoking, and family history of hypertension or diabetes showed no valid association. CONCLUSIONS The study found a high prevalence of hypertension in a rural community. Although, the influence of selected risk factors could not be established, screening and health promotion in rural areas should be intensified.