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To investigate the prevalence, risk factors and impact on some target organs of prehypertension in a province of Vietnam.A case-control study of 3,064 older adults (≥25 years) was conducted in Quang Nam province, Vietnam in 2017, using questionnaire interviews, clinical examinations, and related laboratory tests. Blood pressure, anthropometry, plasma glucose and lipids, IMT were measured. The variables contributing significantly to pre-hypertension were analyzed by multiple logistic regression analysis.The prevalence of prehypertension was 30.7%, hypertension was 31.6% and normal was 37.7%. The risk factors for prehypertension compared with the control group were statistically significant: age > 60 (RR = 1.68, p < 0.001), BMI > 30 (RR = 1.46, p = 0.03), smoking (RR = 1.25, p = 0.001), dyslipidemia (RR = 1.98, p = 0.009), blood glucose level (RR = 1.17, p = 0.028). Effects of prehypertension on target organs: left ventricular hypertrophy (OR = 1.69, p < 0.001), carotid atherosclerosis (OR = 2.46, p < 0.001, p = 0.006), proteinuria (OR = 1.51, p = 0.005).A high prevalence of prehypertension were noted in Quang Nam province, Vietnam. Increasing age, BMI, alcohol consumption, smoking, and dyslipidemia, blood glucose were significantly associated with prehypertension.