OBJECTIVES: To analyze Modifiable Lifestyle Risk Factors (MLRFs) and development of arterial hypertension (AH) and diabetes mellitus (DM) over 10-year follow-up.

METHODS: Design: retrospective cohort study (10 years). Setting and participants: adults from a health plan who answered an epidemiological survey in 2007 (n=46,487). Main exposures: 3 MLRFs - overweight/obesity, mild physical/no activity, and smoking. Main outcome: referred morbidity for hypertension and/or diabetes in another epidemiological survey (2017). Statistical: OpenEpi software for Prevalence Ratios (PR), relative and absolute frequencies, means and standard deviation. For significance, Chi-square tests (Mantel-Haenszel and Fisher's Exact), when p<0.05. Confidence intervals (CI) 95%.

RESULTS: After 10 years, 36.8% individuals without MLRFs remained free of AH (27.7% men / 47.0% women) and 30.7% free of DM (24.0% men / 39.2% women). The PR for AH in MLRFs exposed group compared to not exposed MLRFs group was 2.0 (95% CI 1.4-2.8; p < 0.05, OR 2.6), and 3.1 for diabetes (95% CI 1.7-5.9; p < 0.05, OR 3.5). As greater the number of MLRFs present, higher was the PR for AH (one risk, 1.9; two, 2.0; three, 2.4) and DM (one risk, 2.6; two, 3.8; three, 4.6), with p<0.05 for all analysis.

CONCLUSIONS: These findings suggest an association between overweight/obesity, mild physical/no activity and smoking and development of hypertension and diabetes, diseases that are particularly important because they are also a risk factor for each other. This enhances the morbidity and mortality in these conditions, contributing to a significant impact on the affected population, on the cost of health and on the economy, since they result in disabilities and loss of productivity. The continuous incentive to a healthy lifestyle and the reduction of MLRFS must be on the agenda not only of health professionals, but also of the managers responsible for maintaining the sustainability of the system.