<![CDATA[Diabetes mellitus (DM) is a non-communicable disease with a continuously rising global prevalence and is frequently accompanied by hypertension as a complication that aggravates cardiovascular morbidity and mortality. Low physical activity and poor sleep quality have been proposed as modifiable behavioral risk factors, yet local evidence from primary-care settings in North Sumatra remains limited. This study analyzed the association between physical activity and sleep quality and the risk of hypertension among patients with DM at UPT Puskesmas Medan Johor in 2025. A quantitative analytical study with a cross-sectional design was conducted on 300 respondents selected through systematic random sampling. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ), sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and blood pressure was measured using a sphygmomanometer. Data were analyzed using the Chi-square test and binary logistic regression at α = 0.05. Bivariate analysis showed that physical activity (p = 0.003) and sleep quality (p = 0.001) were significantly associated with the risk of hypertension, while treatment adherence also showed a significant association (p = 0.000). Multivariate analysis indicated that the joint model containing physical activity, sleep quality, and treatment adherence was significantly associated with hypertension (omnibus p = 0.003; Nagelkerke R² = 0.060), although no single variable remained significant after adjustment. Physical activity and sleep quality are behavioral determinants that should be integrated into hypertension prevention programs for DM patients in primary care.]]>
