The incidence of hypertension, diabetes and overweight-obese are emerging increasingly as health problems globally. Oil spills and gas flares pollutants/toxins, though perceived to have resulted in ever increasing polluted air, also contaminated water and soil (1-2), the impact on the physiological functions of the body are poorly understood. The objective of the study was to evaluate the prevalence and the possible relationship between hypertension, diabetes and overweight-obese and the tendency of developing prehypertension and pre-diabetes in rural adults in the Niger Delta region. A cross-sectional, population-based descriptive design was used. A total sample of 250 subjects from Erema / Obagi in Rivers State, aged 20 years and older, exposed in excess of 10 years, were recruited. Blood pressure and fasting blood glucose were recorded by standard methods, body mass index was calculated. Overall, mean value (±SD) of blood pressure (mm Hg), blood glucose level (mmol/L) and body mass index (kg/m2) for the participants were 122.2±18.1/75.1±11.8, 6.6±3.6 and 26.3±4.6 respectively. Prediabetes and diabetes prevalence respectively, were 9.8% and 12.0%. About 30.8% of the participants are pre-hypertensive and 36.4% are hypertensive The mean (±SD)body mass index for males 26.2±4.0 and females 26.4±4.8 fall in the range defined as overweight (p<0.05) . Distribution of blood glucose and blood pressure (%) revealed that 13% pre-hypertensive coexisted with pre-diabetes, whereas 2.4% pre-hypertensive and 18.2% hypertensive had diabetes. Correlation of blood glucose and body mass index showed that 19.6% pre-diabetes and 7.2% diabetes are overweight, while 16.8% diabetes are obese .The correlation between body mass index and blood pressure depicts that 15.4% pre-hypertensive are overweight, 1.4% hypertensive are overweight , 16.8% are both hypertensive and obese . Overall, the prevalence (%) of obesity 16.4, diabetes 24, hypertension18.2, coexisting prehypertension and pre-diabetes 35.0, pre-non-communicable disease 21.7 and main non-communicable disease 23.7 respectively. ANOVA analyses show that diastolic and systolic blood pressure was positively associated with blood glucose and body mass index (P<0.001). Correlation ratio analysis showed that systolic blood pressure and diastolic blood pressure are associated with blood glucose by 11 to 18 – fold. High blood pressure and elevated blood glucose was by 1 to 2- fold. Body mass index and blood glucose was 1-4 fold. High body weight was directly proportional with elevated blood glucose by 1:1- fold. These complex interactions possibly provided the underlying complex mechanisms about the pathophysiology of hypertension-diabetes in humans and its complications. In conclusion, this study provides population based data of high prevalence of both hypertension, diabetes and overweight-obese together with high prevalence of the combination of pre-hypertension and pre-diabetes.