Association and risk factors among injury, physical activity, and adult hypertension and diabetes in a cohort from Southwest China

Hypertension and diabetes have emerged as significant public health concerns in China, with their prevalence potentially linked to injury and physical activity (PA). This study aimed to explore the relationships among hypertension, diabetes, injury, and PA. A cohort study was conducted involving 9,280 adult residents recruited from Southwest China between 2010 and 2012, with 7,920 participants successfully followed up from 2016 to 2020. The results indicated that insufficient PA is a risk factor for hypertension (OR: 1.174; 95% CI 1.046, 1.316; P = 0.006). Factors such as female gender (β = − 0.082), obesity (β = 0.116), and central obesity (CO) (β = 0.149) were directly associated with hypertension. Additionally, hypertension (β = 0.147) and CO (β = 0.069) were directly linked to diabetes. Urban residency (β = 0.069) and injury (β = − 0.051) were associated with total cholesterol levels, while PA (β = − 0.105) was directly correlated with high-density lipoprotein (HDL) levels. Furthermore, women were more likely to experience obesity (β = 0.079) and CO (β = 0.108) (all P < 0.05). The findings suggest that area of residence, injury, and PA are associated with hypertension and diabetes through mediating factors such as HDL, obesity, and CO. It is recommended that residents, particularly women and the elderly, increase their engagement in leisure-time PA and maintain a healthy body mass index and waist circumference.