Purpose: This study examined temporal trends in hypertension prevalence across China (2002-2019), analyzing age-, sex-, and region-specific disparities and identifying key risk factors. Materials and methods: A retrospective analysis was conducted using data from the China Chronic Disease and Risk Factor Surveillance (CCDRFS) program, involving 120,000 adults aged >= 18 years. Descriptive statistics were used to calculate prevalence rates, and multivariable logistic regression analyzed associations with age, sex, BMI, smoking, alcohol consumption, and physical inactivity ResultsHypertension prevalence increased significantly from 18.9% (2002) to 29.6% (2019) (P<0.001). The sharpest rise occurred among adults aged 18-44 years, tripling from 5.3% to 12.8%. By 2019, prevalence was higher in men (34.2%) than women (25.4%), with the western regions showing the highest rates (32.9%). Key risk factors included aging (OR=1.72), elevated BMI (OR=1.85), smoking (OR=1.32), alcohol use (OR=1.28), and physical inactivity (OR=1.18) (P<0.05 for all). Conclusions: Hypertension prevalence in China has surged over two decades, disproportionately affecting younger adults and men. Regional disparities and modifiable lifestyle factors underscore the urgency for tailored prevention strategies targeting high-risk populations. Future research should explore mechanisms driving these trends and optimize integrated interventions to curb this public health burden.