Background: Twentieth century has witnessed the demographic transition in which there is an increased proportion of elderly population. This increased longevity is associated with health and nutritional related problems. Objective: To assess the determinants of hypertension and obesity among the adult population of 50 years and above. Material and Methods: A community based cross-sectional study was carried out in urban and rural areas of Hyderabad and surrounding villages. Information of socio-demographic particulars and history of hypertension and diabetes was collected. Information was also collected regarding substance abuse such as tobacco and alcohol consumption. Anthropometric measurements like weight, height and waist circumference were measured. Results: A total of 81 adults (Men; 48.1%; Women: 51.9%) from rural areas and 58 adults (Men; 56.9%; Women: 43.1%) from urban areas were covered for the study. The prevalence of hypertension was 39.6% among the study subjects and the proportion of known diabetics was 9.8% each in both rural and urban adults. The prevalence of overweight/obesity (BMI ≥ 23.0) and abdominal obesity was about 72% each and the proportion of smokers and alcoholics was 38% and 34%, respectively. Conclusions: In general, the prevalence of hypertension and overweight/obesity was significantly higher among the subjects with sedentary physical activity and those residing in urban areas. Adiposity in terms of BMI and WC was significantly higher in elderly with hypertension as compared to non-hypertensives. Therefore, it is imperative to initiate appropriate intervention measures during the adolescence and early adulthood to adopt and practice healthy life styles.