BACKGROUND This study aimed to investigate the prevalence of arterial hypertension in China. METHODS The Beijing Eye Study 2006 is a population-based investigation including 3,251 subjects aged 45+years. Blood pressure measurements were performed for 3,222 (99.1%) subjects. Hypertension was defined as a systolic blood pressure >= 140 mm Hg and/or a diastolic blood pressure >= 90 mm Hg, and/or self-reported current treatment for hypertension. RESULTS A diastolic blood pressure of >= 90 mm Hg was detected in 106 (3.3%) subjects, and a systolic blood pressure >= 140 mm Hg was measured in 866 (26.9%) subjects. Arterial hypertension was present in 1,500 (46.6%) subjects. Prevalence of arterial hypertension was significantly associated with age (P < 0.001), body mass index (P < 0.001), serum concentration of cholesterol (P = 0.02), diabetes mellitus (P < 0.001; odds ratio: 1.48), family history of hypertension (P < 0.001; odds ratio: 2.96), and rural region (P < 0.001; odds ratio: 2.27). Among the arterial hypertensive subjects, 82.7% were aware of the diagnosis. Awareness of hypertension was significantly associated with urban area, higher age, higher body mass index, and family history of hypertension. Out of the 1,500 hypertensive subjects, 1,106 (73.7%) were treated for arterial hypertension. Out of the treated subjects, 487 (44%) had abnormally high arterial blood pressure measurements. CONCLUSIONS These survey results underscore the fact that hypertension is highly prevalent, relatively poorly treated, and an escalating health challenge in China. As in other studies, people in metropolitan areas had the highest rates of awareness, treatment, and control. It implies that effective public health measures are needed to enhance the treatment, and control rates in the Chinese population, particularly in the rural regions.