This research article published by AME Publishing Company, 2016Background: Mortality and morbidity due to cardiovascular diseases (CVDs) are escalating worldwide, with disproportionately significant worse outcomes in developing countries, due to rapid health and nutrition transition resulting from unplanned urbanization, negative effects of globalization and sedentary lifestyles. Despite the growing trends of CVDs cases in hospital settings especially in Tanzania, still no study has been conducted to evaluate CVD risk factors among patients attending cardiac clinics, to see how they respond to current treatment. This study aimed at assessing lifestyle risk factors and biomarkers associated with hypertension and coronary heart diseases among patients attending cardiac clinics at Kilimanjaro Christian Medical Centre referral hospital in Tanzania. Methods: This was a cross-sectional hospital-based study conducted to determine the prevalence of lifestyle and intermediate risk factors for hypertension and coronary heart disease among patients with hypertension and coronary heart diseases who attended the cardiac clinic at Kilimanjaro Christian Medical Centre referral hospital between April to July 2008. Information on socio-demographic characteristics, medical condition and lifestyle risk factors for hypertension and coronary heart diseases were collected using a structured questionnaire. Blood samples were collected from each patient and analyzed by Cobas Integra and Maglumi analyzers, to detect and quantify important biomarkers. Descriptive statistics were used to analyze sociodemographic, lifestyle risk factors and biomarkers for hypertension and coronary heart diseases. Pearson’s chi-square (χ 2 ) tests were used to associate risk factors for hypertension and coronary heart diseases, and multinomial logistic regression was used to determine independent predictors for hypertension and coronary heart diseases. Results: Of the 100 patients recruited to participate in the study, 65% had hypertension, 23% had coronary heart diseases and 12% had both disease conditions. The most prevalent risk factors for hypertension and coronary heart diseases were: alcohol intake (67%), high blood pressure (59%), physical inactivity (61%), obesity (39%), alanine aminotransferase (43%), high-density lipoprotein (79%), low-density lipoprotein (65%), C-reactive protein (78%), sodium (41%) and potassium (40%). Moreover, age, plasma glucose, alanine aminotransferase, and C-reactive protein were found to be independently and positively associated with hypertension and coronary heart diseases. Conclusions: This study affirmed the exposure of patients to cardiovascular risk factors, despite being under medical management. These findings call for sensitization programs and additional interventions in the management of CVDs among patients attending cardiac clinics in Tanzania hospitals, to include health education on lifestyle risk factors modification and proper dietary habits.