Purpose: Guided by Neuman Systems Model, the study was to ascertain the likelihood intrapersonal and extra-personal risk factors for pre-hypertensive event in adulthood. Design: A cross-sectional study included a convenience sample of 150 adults with pre-HTN in health district of Pissy. Methods: Data were collected by using the WHO STEPS, Spiritual Well-being Scale, Perceived Stress Scale, and blood pressure measurement. Multiple Logistic Regressions and Structural Equation Modeling techniques were used to analyze data. Findings: Among the 150 participants, 41% had low and 59% had high pre-HTN. The analysis revealed income < $500 per month, elevated waist-to-hip ratio in women, obesity, and being widowed predicted pre-HTN SBP/DBP event. Physical inactivity in workplace and current smoke’s cigarette predicted pre-HTN SBP event. In the Spiritual/Religious Well-being Scale, failure in the belief that God is concerned about personal problems, OR=4.65 p<.01; not feeling most fulfilled when in close communion with God, OR=.33, p<.05; failure in relation with God contributes to personal sense of well-being, OR=6.34, p<.018 and OR=4.32, p<.006, predicted pre-HTN SBP/DBP events. In the Perceived Stress Scale, feeling nervous and stressed in the last month, OR=.43, p=.028 predicted pre-HTN SBP. The path analysis unveiled 10% of the variance in pre-HTN event was explained by the socio cultural factors; 4.3% by the psychological; 6.5% of the variance in pre-HTN SBP and 8.0% in pre-HTN DBP accounted for religious well-being factors, while 8.4% in pre-HTN SBP event was justified by existential well-being factors. Lastly, 22.7% of the variance in pre-HTN systolic/diastolic event accounted for the developmental factors. Conclusion: This study finding constitutes a basis for further research interventions tailoring prevention to reduce pre-hypertensive among adults in West Africa, Burkina Faso. Clinical relevance: A nursing model as a Neuman Systems Model provides a holistic assessment of likelihood risk factors for pre-hypertensive event among adults. The model can be used in community and clinical setting not only to assess risk factors and but also to guide quasi-experimental study for prevention as intervention to reduce modifiable diseases.