To explore the incidence trend and epidemiological characteristics of stroke in elderly patients with hypertension, and to provide insights into the prevention and control of stroke in the community.

A followed-up cohort study of 168417 patients with hypertension were retrospectively analyzed, who were followed up in Jiading district in Shanghai from 2002. Relevant information of patients in The Hypertension Follow-up Management System was retrospectively collected, and the general descriptive statistical method and chi-square test were used to analyze the characteristics of high-incidence time and types of stroke in patients with hypertension.

The cumulative incidence of stroke was 10% (male 10.11%, female 9.89%) among 138284 patients with hypertension (χ²_sex=42.667, P＜0.001). The older the patient was, the higher the cumulative incidence was (χ²_age=315.775, P＜0.001). The most common type of stroke was cerebral infarction (86.86%), followed by cerebral hemorrhage (7.16%) and unclassified stroke (5.98%). The higher the blood pressure of patients was, the higher the cumulative incidence of stroke was (χ²_{BP grad}=58.095, P＜0.001). The cumulative incidence of stroke in patients with pure high diastolic blood pressure (28.69%) was higher than that in patients with pure high systolic blood pressure (9.25%) and high blood pressure (10.32%) (χ²_{HP type}=37.451, P=0.005). Three incidence peaks of stroke in patients with hypertension were within one year, four years and eight years after registered. May and July were the relative peak months of stroke (χ²_month=170.874, P＜0.001). The cumulative incidence of stroke was different among different seasons, showing seasonal characteristics (χ²_quarter=76.143, P＜0.001).

The major stroke type in patients with hypertension was cerebral infarction. The cumulative incidence of stroke was affected by sex, age, blood pressure value, and hypertension type. Incidence of stroke presents seasonal variations.