Background Hypertension is one of the most common chronic diseases which threatens human health. How-ever,epidemic data of hypertension guided by new ACC hypertension guideline is limited. Methods Residents from four cities in urban and country areas were enrolled by the probability proportional to size method in Guang-dong province,China. Results A total of 19,031 participants were enrolled. The age-standardized prevalence of hypertension was 32.07％ guided by previous guideline and 56.67％guided by the new guideline. Notably, when guided by new guideline,the prevalence of hypertension in younger(15～24 years,313％;25～34 years, 270％;35～44 years,186％),lower body mass index(BMI<24 kg/m2,102％)and high-educated(undergradu-ates,194％;postgraduates,137％)participants increased more compared to older(55～64 years,47％;65～74 years,33％;75～84 years,23％),obesity(BMI≥28 kg/m2,46.6％)and low-educated(primary school,42％) participants. Age,gender,alcohol taking,BMI,waist circumference,education,medical insurance and hyper-tension family history were found to be independent risk factors of hypertension in new guidelines. Conclusions The prevalence of hypertension changed greatly when guided by the new hypertension guideline. When applying the new hypertension guideline,subjects with younger age,lower BMI and high-educated tend to be more sus-ceptible to hypertension compared to traditional high risk population. Further studies are needed to explore indica-tors that can predict the morbidity of hypertension.