In this assessment of cardiovascular risk factors, we examined the association between dietary habits and blood pressure (BP) according to the World Health Organization (WHO) CARDIAC Study protocols in three Chinese populations aged 47-57 in Guangzhou prefecture (GZ group; 141 males, 158 females), Guiyang prefecture (GY group; 101 males, 103 females) and Taiwan (TW group; 102 males, 98 females). The same survey was repeated 10 yr later in the GY group to follow-up the past trends (MONALISA study). The observed systolic BP (SBP), diastolic BP (DBP), and body mass index (BMI), as well as the rates of hypertension, obesity and antihypertensive medication use were significantly higher in both genders in the TW group compared to the groups GZ and GY. There was no significant difference in SBP or DBP in either gender between groups GZ and GY. Blood analyses revealed that the levels of serum total cholesterol (T-CHO), and HbAlc, and the rates of hypercholesterolemia and high HbAlc were significantly higher in both genders in the TW than in the GZ and GY groups. No significant difference among the populations was observed in 24-h urinary sodium or magnesium excretion in either gender. In the combined total populations of men and women, however, significant positive correlations were observed between BMI and each of SBP, DBP, T-CHO, and glycohemoglobin in both genders. A food frequency analysis revealed significantly greater meat consumption and significantly less tea consumption and vegetable intake in the TW than in the GY and GZ groups. Both SBP and DBP have increased significantly over the past 10 yr in the GY group in both genders, and T-CHO as well as the rate of hypercholesterolemia increased over the same period in both genders. Hypertension is a serious public health problem in developed countries because of its high prevalence and the concomitant increase in the risk of cardiovascular and renal diseases (1-4). Although many animal experiments point toward an important genetic contribution in the etiology of hypertension, the relative contributions of environmental and genetic factors in the etiology of hypertension in humans remain controversial. Several studies (5, 6) have documented marked differences in the prevalence of cardiovascular diseases (CVD) among various countries, races and regions throughout the world, and have shown that these differences are largely attributable to changing lifestyles (especially changes in traditional dietary habits) rather than genetic factors (7).Environmental factors, such as dietary habits, are thought to play a significant role in the development of obesity and hypertension in many developing countries. In China, cardiovascular diseases, including hypertension and stroke, have been major causes of death over the past decade. According to World Health Organization (WHO) reports (8, 9), the improvement of dietary-related factors is critical to primary prevention of essential hypertension, atherosclerosis and coronary heart diseases.In the present study, we evaluated the dif...