Abstract: Objective To analyze the prevalence and influencing factors of high normal blood pressure in residents aged 18 years and over in Zhengzhou city, so as to provide a reference for the prevention of cardiovascular disease. Methods A multi-stage random sampling method was conducted. From June to November 2018, a total of 6 809 residents aged 18 and above in Zhengzhou City were selected for questionnaire survey. The height, weight, waist circumference and blood pressure were measured. Blood samples were collected for blood glucose and blood lipid detection. The prevalence of high normal blood pressure in different characteristic populations was compared. Multivariate logistic regression analysis was used to analyse the influencing factors of high normal blood pressure. Results In 2018, the prevalence of high normal blood pressure in residents aged 18 and over in Zhengzhou city was 35.3%（standardized rate was 35.7%）, which was higher in male than in female residents（40.8% vs 31.4%, χ~2 =63.227,P ＜0.001）,and higher in rural adults than in urban adults（39.1% vs 31.6%,χ~2=42.432, P＜0.001）. Among the adults without history of hypertension, 49.8% had high normal blood pressure. The prevalence of high normal blood pressure increased first and then decreased with age（χ■ = 55.466, P＜0.001）, increased before the age of 50 and decreased after the age of 50. In the subjects with high normal blood pressure, the dyslipidemia rate was 33.1%, and the abnormal glucose metabolism rate was 31.0%. Multivariate logistic regression analysis showed that living in rural areas（OR=2.305, 95%CI 2.028-2.620）, men（OR=1.934, 95%CI 1.695-2.208）, old age（compared with 18-＜30 years: 40-＜50 years, OR=1.626, 95%CI 1.341-1.971; 50-＜60 years, OR=1.909, 95%CI 1.568-2.325;60-＜70 years, OR=1.982, 95%CI 1.548-2.538;≥70 years, OR=2.661, 95%CI 1.882-3.763）, educational level（compared with ＜middle school: OR=1.825, 95%CI 1.553-2.114 for middle and high school; OR=3.440, 95%CI 2.847-4.062 for college）, overweight and obesity（compared with normal body mass: OR=1.568, 95%CI 1.334-1.841 for overweight; OR=2.581, 95%CI 2.050-3.251 for obesity）, central obesity（OR=1.247, 95%CI 1.061-1.467）, dyslipidemia（OR=1.209, 95%CI 1.041-1.404）, prediabetes（OR=1.698, 95%CI 1.347-2.140）, diabetes（OR=1.382, 95%CI 1.149-1.663）, smoking（OR=1.748, 95%CI 1.509-2.026） and drinking（OR=1.279, 95%CI 1.126-1.454） were risk factors for the prevalence of high normal blood pressure. Conclusions The prevalence of high normal blood pressure in residents aged 18 and over in Zhengzhou is at a high level and is affected by many risk factors. The prevalence of dyslipidemia and abnormal glucose metabolism is relatively high in high normal blood pressure population.