Abstract
<jats:p>Cardiovascular and chronic kidney disease place a growing burden on low-resource settings, and commercial drivers, whose occupation combines prolonged sitting, irregular meals and limited contact with routine health services, are an understudied high-risk group in Nigeria. Self-medication, common across the country, may compound this risk by masking symptoms or adding a nephrotoxic burden to an already strained cardio-metabolic system. This cross-sectional analytical study examined cardio-metabolic and renal risk awareness, self-medication practices and their predictors among 435 commercial bus drivers recruited from motor parks in Ebonyi State, southeast Nigeria, using a multistage sampling approach. Data were collected through a structured interviewer-administered questionnaire and direct clinical and anthropometric measurement, including blood pressure, random blood glucose, body mass index and urine protein. Self-medication was reported by 89.4% of participants, and none had health insurance coverage. Awareness of cardio-metabolic and renal risk was unevenly distributed across the sample. Current smoking independently predicted poor awareness after adjustment (adjusted odds ratio 0.46, 95% confidence interval 0.29 to 0.71), while lower educational attainment and longer driving tenure independently predicted lower odds of self-medication. Clinical measurement identified hypertension in 12.9% and diabetes range glucose in 7.1% of participants, and more than four in five of these cases had never been previously diagnosed. Obesity was present in 25.1% of drivers. These findings show that cardio-metabolic and renal disease is accumulating largely undetected in this occupational group, that self-medication is close to universal, and that health insurance coverage is absent altogether. Occupational health programmes targeting commercial drivers should combine routine screening for hypertension and diabetes with structured education on the risks of unsupervised medicine use, particularly given the high burden of undiagnosed disease revealed by direct clinical assessment in this study.</jats:p>