Objective The study aimed to assess the medication compliance status in hypertensive patients combined with diabetes mellitus and to explore the influencing factors based on socio-demographic characteristics,lifestyle behav-iors,and medical records.Methods Between November 2021 and March 2022,a total of 381 patients from four com-munity hospitals in Ningbo were randomly selected as participants.They were surveyed using a questionnaire based on the Chinese version of the 8-item Morisky medication adherence scale(MMAS-8).Binary logistic analysis was used for data analysis.Results The average medication adherence score for 381 patients combined hypertension and diabetes mellitus was(5.67±1.05)points,with 163 patients(42.78%)demonstrating high adherence.Univariate analysis revealed that significant associations between medication adherence and various factors,including gender,medical payment methods,daily medication types,daily medication frequency,and alcohol consumption(P<0.05).Multiple logistic regression re-vealed that patients with medical insurance for urban workers payment had higher medication compliance(OR=2.141,95%CI:1.346-3.405,P=0.001).Additionally,patients with a daily medication frequency of ≥3(OR=0.438,95%CI:0.208-0.921,P=0.030)and those with daily medication types ≥3(OR=0.342,95%CI:0.216-0.540,P<0.001)exhibited lower medication compliance.Conclusion The medication compliance among patients with com-bined hypertension and diabetes mellitus is suboptimal,primarily influenced by factors such as daily medication frequen-cy,daily medication types,and medical payment methods.Therefore,proactive interventions should be implemented based on these influencing factors.