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Life sciences · Journal article
Discover Public Health · October 16, 2026
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Workplace-based health assessment may identify cardiometabolic abnormalities in low-resource settings where metabolic testing may be limited. Teachers constitute an important occupational group in sub-Saharan Africa, yet evidence on clustering of cardiometabolic risk factors remains limited. This study assessed the prevalence and clustering of selected cardiometabolic risk factors among participants from selected schools in a Ghanaian municipality. This cross-sectional study included 166 primary school teachers. Three risk components were assessed: elevated blood pressure (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg), overweight/obesity (BMI ≥ 25 kg/m²), and elevated fasting glucose (≥ 7.0 mmol/L). Clustering was defined as the presence of two or more components and was not intended to represent metabolic syndrome. Firth penalized logistic regression examined the association between elevated waist-to-hip ratio (WHR) and clustering after adjustment for age, sex, alcohol use, and family metabolic risk. A sensitivity analysis excluded BMI from the clustered-risk definition. Clustering of selected cardiometabolic risk factors was observed in 15.1% of participants. Elevated blood pressure, overweight/obesity, and elevated fasting glucose were present in 30.1%, 23.5%, and 13.9%, respectively. Participants with clustering were older and had higher WHR. Elevated WHR was associated with higher odds of clustering in the adjusted model (adjusted OR = 4.49, 95% CI: 1.53–13.15, p = 0.006), and the association persisted after excluding BMI from the clustered-risk definition. Clustering of selected cardiometabolic risk factors was observed in 15.1% of participants. Elevated WHR was associated with clustering and may represent an anthropometric marker requiring further evaluation in workplace-based cardiometabolic health assessment.