Lifestyle Factors and Their Influence on Blood Pressure and Glycemic Control in Patients With Type 2 Diabetes Mellitus and Hypertension: A Cross-Sectional Study

Background:Type 2 Diabetes Mellitus (T2DM) and hypertension are prevalent chronic conditions that often coexist, contributing significantly to cardiovascular morbidity and mortality. These conditions share common pathophysiological mechanisms and are largely influenced by modifiable lifestyle factors such as physical inactivity, poor dietary habits, stress, and inadequate sleep. Despite advancements in pharmacotherapy, achieving optimal glycemic and blood pressure (BP) control remains a challenge in routine clinical practice, underscoring the importance of lifestyle-based interventions. Objectives: This study aims to evaluate the impact of various lifestyle factors—specifically dietary habits, physical activity, sleep quality, and perceived stress—on the clinical outcomes of blood pressure and glycemic control (measured via HbA1c) among patients with coexisting T2DM and hypertension. The study further seeks to determine whether healthier lifestyle patterns are significantly associated with improved metabolic and cardiovascular parameters in this population. Methods: A cross-sectional observational study was conducted involving 300 adult patients diagnosed with both T2DM and hypertension, who were attending outpatient services at a tertiary care hospital. Participants were selected via consecutive sampling over a 6-month period. Lifestyle factors were assessed using validated instruments: Ÿ Physical activity: International Physical Activity Questionnaire (IPAQ) Ÿ Sleep quality: Pittsburgh Sleep Quality Index (PSQI) Ÿ Stress: Perceived Stress Scale (PSS) Ÿ Dietary behavior: Semi-quantitative Food Frequency Questionnaire (FFQ), scored on a 5-point scale based on frequency and quality of healthy food intake. Each patient was assigned a composite Lifestyle Score (range 4–20), derived from the summation of individual scores on physical activity, sleep, stress, and diet. Clinical parameters including systolic and diastolic blood pressure (SBP, DBP) and HbA1c levels were recorded. Statistical analysis was performed using ANOVAand Pearson's correlation to determine associations between lifestyle scores and clinical outcomes. Results: Of the 300 patients analyzed, those in the 'Good Lifestyle' category (score 15–20) exhibited significantly lower SBP (mean = 128.4 mmHg), DBP (mean = 78.1 mmHg), and HbA1c levels (mean = 6.7%) compared to patients in the 'Poor Lifestyle' category (score ≤ 8), who had elevated SBP (mean = 144.3 mmHg), DBP(mean = 86.4 mmHg), and HbA1c (mean = 8.1%). Key findings include: Ÿ Astrong inverse correlation between physical activity (IPAQ scores) and both SBP(r = –0.31, p < 0.01) and HbA1c (r = –0.28, p < 0.01). Ÿ Patients with sleep duration >7 hours/day had better BPand HbA1c profiles than those with inadequate sleep (<6 hours/day). Ÿ High perceived stress levels (PSS >20) were associated with poor metabolic control and higher BPvalues. Ÿ Multivariate analysis confirmed that lifestyle score was an independent predictor of HbA1c and BPlevels after adjusting for age, gender, BMI, and duration of illness. Conclusion: This study highlights the substantial impact of lifestyle behaviors on the management of T2DM and hypertension. Patients who engaged in healthier lifestyle practices had significantly better control over both blood pressure and glycemic parameters. These findings reinforce the critical need for integrating structured lifestyle interventions—including physical activity promotion, stress management, sleep hygiene, and dietary counseling—into the routine care of patients with these chronic conditions. Such measures could lead to improved quality of life and a reduction in long-term cardiovascular and metabolic complications.