Objective: The current study was performed to estimate the temporal trend and geographic disparities in blood pressure and thus to provide accurate population attributable fraction (PAF) of cardiovascular disease (CVD) burden attributable to raised blood pressure at national and provincial in China, which is crucial to inform and improve BP control measures. Design and method: For this analysis, we pooled three national large population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 2005 to 2018 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 2877 counties of 31 provinces in China. Data from a prospective cohort from 2002–2019 selected randomly from China Hypertension Survey, enrolling more than 30 000 individuals aged 35 years or over without CVD at baseline, was used to calculate the multivariable-adjusted HRs by Cox regression. HRs along with the blood pressure levels, were used to calculate the attributable burden of CVD. Results: We pooled 13.1 million adults to estimate blood pressure. The national systolic and diastolic BP was 136.7 and 83.8 mmHg. The systolic and diastolic BP slightly decreased from 2005 to 2018 in national level, while increased in several provinces with lower socioeconomic levels. As for PAF, the national PAFs for CVD associated with hypertension was 17.85% and 24.66% for male and female, respectively. At provincial level, the PAFs ranged from 24.17% in Beijing to 12.13 % in Hunan for male, 31.49% in Beijing to 19.05% in Jiangxi for female, there were 3 provinces (Beijing, Tianjin and Shanghai) with PAFs over 29.00%, while in another three provinces (Hunan, Jiangxi, and Guangxi), the PAF was lower than 15.00%. The PAF was higher among those younger than 65 years compared with those 65 years or older. Conclusions: The highest blood pressure levels have shifted from high-income provinces to low-income provinces, with remarkable provincial-level disparity in CVD burden attributable to hypertension. Regional targeted considerations may help to further tailor BP control strategies for reducing the burden of CVD and disparity.