Objective  To establish a community-based hypertension cohort in order to carry out follow-up management of hypertension and related risk factors and evaluate the effectiveness of the management.

Methods A general hypertension survey was conducted in Wuyuan County. The baseline survey was conducted from March to August 2018, including questionnaire survey, physical examination and biochemical tests. The first follow-up was completed from June to August 2022.

Results A total of 14 234 hypertensive patients with an average age of (63.8±9.4) years were included in the baseline survey, including 6 721 males (47.2%). 14232 hypertensive patients completed follow-up surveys, and 2 were lost to follow-up, the completion rate of follow-up was 99%. During a 4-year follow-up, a total of 806 deaths occurred. Compared with baseline, the follow-up results showed that systolic blood pressure, diastolic blood pressure, fasting blood glucose, homocysteine, and serum uric acid in hypertensive patients decreased, the proportion of blood glucose reaching the target increased, and the proportion of hyperuricemia decreased, and the differences were statistically significant (all P ＜ 0.05). Multivariate Cox regression analysis indicated that, after adjusting for confounding factors, the risk of all-cause mortality was higher for patients with hypertension who had two, three, or four comorbidities compared to those with one comorbidity. The hazard ratios (HR) with 95% confidence intervals (95%CI) were 1.288 (1.061 to 1.564), 1.463 (1.176 to 1.820) and 1.784 (1.335 to 2.383), respectively.

Conclusion Through follow-up management, hypertension and related risk factors in the Wuyuan hypertension cohort have been effectively controlled.