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To analyze the characteristics, health resource use and medical costs of patients with hypertension among China Basic Medical Insurance (BMI) participants in 2014.This retrospective analysis used the data of 33 cities from China health insurance database in 2014. Patients aged ≥ 18 years and diagnosed with hypertension were identified. Those with the diagnosis of cancer or organ failure were excluded. Totally 298,263 patients were identified.1) Of all patients, the mean age was 62.5 years and 49.5% were male. Most of the patients were covered under the urban employee BMI (92.1%) and from Eastern China (91.5%). The top three comorbidities were coronary heart disease (27.2%), diabetes (20.3%) and stroke (7.1%). 2) Of all patients, 86.3% received only outpatient treatment and 13.8% received inpatient treatment. Totally 5.77 million outpatient visits happened (i.e. 19.7 visits per patient on average), and 33.7% happened in tertiary hospitals. Besides, 64,594 hospitalizations happened totally (i.e. 1.6 admissions per hospitalized patient on average), of which 54.7% were in tertiary hospitals. As to the utilization of antihypertensive drugs, only 46% received ≥ 2 prescriptions. 3) The all-cause medical expenses for all patients was RMB ¥1.9 billion totally (59% for outpatient and 41% for hospitalizations). Of the total costs, only 7.6% was spent on antihypertensive drugs. The average cost was ¥286.4 per outpatient visit and ¥9210.4 per hospitalization for patients with a primary diagnosis of hypertension.Hypertension patients caused substantial costs, most of which happened in tertiary hospitals, especially the costs for hospitalization. The cost of antihypertensive drugs seemed not burdensome, but the utilization seemed suboptimal.