Objective To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS).

Design Population based survey of residents in an HDSS.

Setting Webuye Division in Bungoma East District, Western Province of Kenya.

Patients 4037 adults ≥18 years of age.

Interventions Home based survey using the WHO STEPwise approach to chronic disease risk factor surveillance.

Main outcome measures Self-report of high blood pressure, high blood sugar, tobacco use, alcohol use, physical activity, and fruit/vegetable intake.

Results The median age of the population was 35 years (IQR 26–50). Less than 6% of the population reported high blood pressure or blood sugar. Tobacco and alcohol use were reported in 7% and 16% of the population, respectively. The majority of the population (93%) was physically active. The average number of days per week that participants reported intake of fruits (3.1 ± 0.1) or vegetables (1.6 ± 0.1) was low. In multiple logistic regression analyses, women were more likely to report a history of high blood pressure (OR 2.72, 95% CI 1.9 to 3.9), less likely to report using tobacco (OR 0.08, 95% CI 0.06 to 0.11), less likely to report alcohol use (OR 0.18, 95% CI 0.15 to 0.21) or eat ≥5 servings per day of fruits or vegetables (OR 0.87, 95% CI 0.76 to 0.99) compared to men.

Conclusions The most common cardiovascular risk factors in peri-urban western Kenya are tobacco use, alcohol use, and inadequate intake of fruits and vegetables. Our data reveal locally relevant subgroup differences that could inform future prevention efforts.