Cardiometabolic Disease in Rural Southeastern Communities

BACKGROUND: Cardiometabolic disease disproportionately affects rural communities, but early behavioral and physiological risk indicators are understudied in these populations. OBJECTIVES: The aim of this study was to characterize cardiometabolic health in a rural southeastern U.S. community. Primary objectives included assessing the prevalence of blood pressure and glycemic alterations and examining associations between modifiable factors such as sleep, nutrition, and educational attainment. A secondary objective was to assess community interest in future hypertension research. METHODS: A cross-sectional study was conducted during a nurse-led community health screening event at a rural street festival. Participants were recruited using nonprobability convenience sampling and completed structured surveys and clinical screenings. Regression models evaluated relationships between predictors and blood pressure outcomes. Moderation analyses evaluated the role of sex. RESULTS: Participants with high school education had significantly higher SBP and MAP readings compared with those with bachelor's degrees. Sleeping ≤6 hours predicted higher SBP, MAP, and glucose. Younger adults exhibited significantly higher BP levels across all models. The effects of education and sleep on BP were considerably stronger among men, but women exhibited higher BP across models, which was a reversal of typical epidemiological patterns. DISCUSSION: Modifiable factors such as education and sleep were associated with early cardiometabolic risk in rural communities. Findings support biobehavioral models integrating metabolic, inflammatory, and behavioral indicators for early risk detection, especially in younger ages. Nurses are well-positioned to lead interdisciplinary initiatives addressing cardiometabolic risk in rural communities. Future studies should prioritize scalable prevention strategies targeting young adults before clinical disease emerges.