Shandong Province is located in the east of China. The province is characterized by robust economic development, with a rural population accounting for 56% of the total population. However, no data are available regarding temporal changes in the prevalence, awareness, treatment and control of hypertension among this population. Three independent cross-sectional surveys were performed in 1991 (n=8359), 2002 (n=18922) and 2007 (n=20167) in the rural area population, aged 35-74 years. The sampling included a survey on blood pressure and associated risk factors. Although the rate of smoking and alcohol consumption decreased significantly from 1991 to 2007, the prevalence of overweight and obesity increased, whereas that of high-strength physical activity decreased remarkably. In 1991, 2002 and 2007, the prevalence of prehypertension was 33.8, 61.5 and 54.6%, respectively. The prevalence of hypertension was 20.4, 24.5 and 30.6%, respectively. Overall, the rate of hypertension awareness, treatment and control showed a steady increase over the 16-year period, although the control rate of hypertension is still far from being satisfactory. In conclusion, among the Chinese rural population, the prevalence of prehypertension and hypertension increased significantly from 1991 to 2007. Public health programs are required to improve this situation in Chinese rural populations.