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This study aimed to assess the prevalence and related factors of obesity-related hypertension among adults aged 40 to 79 years in Southwest China.From September 2013 to March 2014, multistage stratified sampling method was conducted in 10589 people aged covered from 40 to 79 years living in Chengdu and Chongqing, using questionnaire and physical measurements. The definition of obesity-related hypertension was based on Chinese expertconsensus on obesity-related hypertension management.The prevalence of obesity-related hypertension and hypertension was 16.6% and 37.6% among all participants. The prevalence of obesity-related hypertension was higher in females than in males (17.9%VS14.3%,P < 0.001). The prevalence of obesity-related hypertension were 5.9%, 15.8%,24.5% and 31.8% among adults aged 40–49, 50–59, 60–69 and over 70, respectively. Participants with obesity-related hypertension than those with non-obesity-related hypertension had higher prevalence of hypertriglyceridemia, diabetes,and hyperuricemia (Pall < 0.0001). Multivariate logistic regression analysis showed that aging,female,current smoking,family history of hypertension were positively correlated with obesity-related hypertension, higher education and having spouse were negatively correlated with obesity-related hypertension.The prevalence of obesity-related hypertension was high among adults aged 40 to 79 years in southwest China.Cardiometabolic abnormalities among obesity-related hypertension are more serious than those with non-obesity-related hypertension. Aggressive strategies aimed at prevention and treatment of obesity-related hypertension are needed.