Abstract:Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A crosssectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched with 320 nonhypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. Pre-diabetes was defined as fasting plasma glucose of 100-125 mg/dL and /or plasma glucose level of 140-199 mg/dL two hours after a 75g oral glucose load. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern. The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.