Abstract: Objective To explore the relationship between cumulative blood pressure and the risk of cognitive function decline in middle-aged and elderly individuals in China. Methods The data were derived from the baseline of the China Health and Retirement Longitudinal Study from 2011 to 2018, focusing on individuals without cognitive impairment-related diseases. Cumulative blood pressure was estimated using the area under the curve for measurements taken at baseline and during follow-up（2011-2015）. The indicators included cumulative systolic blood pressure（cumSBP） and cumulative diastolic blood pressure（cumDBP）. CumSBP（mmHg·years） was stratified based on the following criteria: low level（＜360）; normal level（360-＜480）; higher level（480-＜560）; highest level（≥560）. CumDBP（mmHg·years） was stratified based on the following criteria: low level, ＜240; normal level（240-＜320）; higher level（320-＜360）; highest level（≥360）. The cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination（MMSE） in 2018. Participants were divided into cognitive decline and normal cognitive groups. Multiple logistic regression model was used to analyze the association between cumulative blood pressure and cognitive function decline. Results A total of 10 366 participants were included in the study. Among them, 4 715 were male, accounting for 45.5%, and 5 651 were female, accounting for 54.5%. By 2018, the number of individuals with cognitive decline was 4 831, with a prevalence rate of 46.6%. After adjusting for confounding factors, compared to the group with normal cumSBP, the group with the highest cumSBP level exhibited a significantly increased risk of cognitive decline, with an OR of 1.298（95%CI 1.134-1.486）. With the increase in cumSBP, the risk of cognitive decline also increased. CumDBP was not assoicated with cognitive function decline. Conclusion CumSBP is a risk factor for cognitive decline, while cumDBP is not associated with cognitive decline.