Although evidence suggests that lifestyle interventions can reduce blood pressure (BP) and glucose levels, there is little information about the feasibility of such interventions when implemented in community settings. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose in the middle-aged and older Chinese population. By using a cluster randomisation approach, 474 participants from two communities were assigned to the intervention group which received intensive health education and behavioural intervention, or the control group which received conventional education. Linear mixed models were used to compare between-group differences on change in BP and fasting glucose after 6, 12 and 24 months. At the 12-month follow-up, the intervention group experienced significantly reductions in systolic BP (−4.9 vs. 2.4 mmHg; mean difference [MD] −7.3 mmHg; p < 0.001), diastolic BP (−1.9 vs. 1.9 mmHg; MD −3.8 mmHg; p < 0.001) and fasting glucose (−0.59 vs. 0.08 mmol/L; MD −0.67 mmol/L; p < 0.001). These differences were sustained at the 24-month follow-up. With only two communities, it was not possible to adjust for potential clustering by site. This approach of lifestyle interventions conducted through primary care services may be a potential solution for combating hypertension and diabetes in a resource-limited country context in China. Full article