Background Subjects with prehypertension are at a high risk of developing hypertension.Little is known about the predictors of progression from prehypertesion to hypertension in rural Chinese adults.Methods A population-based sample of 15,061 rural Chinese aged ≥ 35 years with prehypertension free cardiovascular diseases at baseline were followed-up from 2004-2006 to 2008.Incident hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg,diastolic BP ≥ 90 mmHg,or current use of antihypertensive medications.