Aims: The aim of this study was to assess the association between overweight, diabetes, stress and other postulated risk factors for a high blood pressure, on the risk of hypertension. Methods and Results: This matched case–control study included 228 cases randomly selected in a rural adult population in Yarumal – Antioquia, Colombia. For every case, one control, individually matched by age (± 5 years), sex and residence, was selected from the general population. Conditional logistic regression was used to estimate odds ratios (OR). Obese people (body mass index (BMI) ≥ 30 kg/m2) showed an increased OR of hypertension compared to those with a BMI < 25 kg/m2, OR: 3.83 [95% confidence interval (CI): 1.83–8.00]. A high level of psychological stress was associated with hypertension (measured on a tension–anxiety scale), OR: 5.02 (95% CI: 2.25–11.19). A positive association was also observed for diabetes although it was of borderline significance, OR: 2.58 (95% CI: 0.88–7.55). Having a family member with hypertension or myocardial infarction was related to a higher risk of hypertension (p < 0.05). Conclusions: This study provides evidence that BMI, stress (feelings of anxiety or tension), and diabetes are independently associated with an increased risk of hypertension in a rural area of Colombia.