The rapid urbanization in China has brought with it some health benefits, but it also brought about a negative influence on the lifestyle of residents. We conducted this study to assess the change in hypertension-related knowledge and behavior from 2013 to 2016 among recently urbanized residents and determine their association with socioeconomic status (SES). This research used data from two cross-sectional studies conducted in Hezuo community in Chengdu, Sichuan province of China. A total of 2268 and 2601 individuals, respectively, participated and completed standard questionnaires. According to the results, the median (IQR) scores of health knowledge was 1 (0,3) and 3 (1,5), respectively, (p < 0.001) and the median (IQR) scores of health behavior was 6 (5,6) and 5 (5,6), respectively, (p < 0.001) in 2013 and 2016. The rate of sufficient knowledge increased from 8.8% to 18.1% (p < 0.001), while the rate of correct behavior decreased from 54.5% to 45.5% (p < 0.001) in three years. Logistic regression analysis showed that higher education was associated with sufficient hypertension-related knowledge (p < 0.05), and those with higher education, unemployment, and retirement were more likely to have sufficient behavior (p < 0.05). The impact of SES on knowledge was stable between 2013 and 2016. The behavior difference between the middle school educated and the illiterate increased from 2013 to 2016 (p < 0.05), and the behavior difference between the unemployed and manual workers decreased from 2013 to 2016 (p < 0.05). Our results revealed that hypertension-related knowledge improved with no corresponding improvement in self-reported behavior among recently urbanized residents from 2013 to 2016. Organizational strategy should be implemented to improve health education on knowledge, and what is more, translate knowledge into behavior. All these measures should be given more attention to the lower educated and manual workers among recently urbanized residents to eliminate the SES disparity.
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