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Background: Stroke has been the leading cause of death in China and hypertension accounts for about one-third of deaths due to stroke in Chinese adults. The current study aimed to examine the secular trends of stroke and hypertension in two population-based samples.Methods: The study included three cohorts (2004-2008, n=38,949; 2008-2010, n=38,264; and 2013-2016, n=8,880) from two population-based studies: Fuxin Cardiovascular Cohort Study (FCCS) and Northeast China Rural Cardiovascular Health Study (NCRCHS).Results: There was a significant increasing trend for incidence of stroke in both men and women (P for trend <0.001). The age-adjusted incidence of stroke (per 100,000 person-years) among the 3 Cohorts was 575.3, 893.0, and 1382.7 in men and 358.9, 456.5, and 1046.2 in women, respectively. With the 2004 Cohort as the reference group, we observed a 52.9% increase in 2008-2010 and a 169.9% increase in 2013-2016 among men. However, hypertension incidence decreased steeply in both sexes from 2004-2008 (15.2 in men and 12.6 in women per 100 person-years) to 2013-2016 (9.6 in men and 7.1 in women per 100 person-years) (P for trend <0.0001).Conclusions: Incidence of stroke has increased and incidence of hypertension decreased since 2004, which has implications for prevention of both diseases in China.