Abstract: Objective To explore the joint association of dietary patterns and physical activity(PA) with hypertension among urban residents in Nanjing city, Jiangsu province, and to provide references for the prevention and control of hypertension.Methods With multi-stage stratified cluster random sampling, a total of 3 376 urban residents aged 30-75 years were recruited from 7 communities of two districts and screened for hypertension;then 418 hypertensives newly diagnosed were assigned into a case group and 782 residents with normal blood pressure into a control group.All participants completed a questionnaire survey and physical examination.Results The proportions of participants mainly having western dietary pattern(WDP) and prudent dietary pattern(PDP) were 58.37% and 41.63% for the cases and 23.40% and 76.60% for the controls;the proportions of participants with and without sufficient PA were 43.78% and 56.22% for the cases and 51.02% and 48.98% for the controls, respectively.Adjusting for gender, age, education, marital status, occupation, family annual income, and body mass index(BMI), multivariate conditional logistic regression analysis showed that the odds ratio(OR) of hypertension for the participants with PDP was 0.208(95 confidence interval95%CI=0.160-0.270) compared to those with WDP;sufficient PA was associated with lower risk of hypertension(OR=0.756, 95%CI=0.593-0.962);compared to the participants with insufficient PA and WDP, the OR of hypertension was 0.124(95%CI=0.084-0.183) for those with PDP and insufficient PA, 0.357(95%CI=0.237-0.539) for those with WDP and sufficient PA, and 0.103(95%CI=0.068-0.156) for those with PDP and sufficient PA, respectively.Conclusion The study indicates that both sufficient physical activity and healthy dietary pattern can reduce the risk of hypertension and the combination of the two factors can play a more important role in the prevention of hypertension.