Background: Although previous studies have shown the relationship between different parental factors and children's blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic factors, the current study aimed to distinguish parental risk clusters and their effects on the incidence of hypertension in school-age children over thirteen years.Methods: Parental characteristics of 1669 children including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status and diabetes were considered to categorize parents into low and high risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal clusters. Using Cox proportional hazard model, results on association between parental risk clusters and HTN incidence in children were reported in five different models. Results: Mean age of children was 13.96±2.89 years and 51.2% (n=854) of them were girls. MetS, HTN and weight status were the most important factors distinguishing low and high risk parental clusters respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71-106) and 38 (95% CI: 29-52), in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI: 40-63) and 80 (95% CI: 64-102) in maternal low and high risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high risk clusters were 53 (95% CI: 41-70) and 68 (95% CI: 56-84), respectively.Conclusion: Our findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.