OBJECTIVE To explore the association between plasma fibrinogen (FIB) concentration and ten-year change in blood pressure in Chinese population aged 35 - 64. METHODS A prospective cohort comprising 2683 subjects was established in Beijing in 1992. Blood pressure (BP) and other traditional cardiovascular risk factors were assessed in 1992 and 2002 respectively, and plasma FIB concentration was measured in 1992. The association of plasma FIB with ten-year change in blood pressure was analyzed. RESULTS (1) The median concentration of FIB among this population was 3.8 g/L (3.2 - 4.3 g/L), and the percentage of the people with abnormal FIB concentration (FIB > 4.0 g/L) was 33.4% in 1992. The FIB concentration of the females was higher than that of the males (P < 0.01) and the FIB concentration of the hypertensive subjects was significantly higher than that of the non-hypertensive subjects (P < 0.05), however, there was no significant difference in the abnormal FIB rate among different age groups. (2) Compared with the BP levels in 1992, the systolic BP and diastolic BP of this population increased by 10.0 mm Hg and 5.0 mm Hg respectively in 2002. The partial correlation coefficients of baseline FIB concentration with ten-year difference for systolic and diastolic BP were 0.125 (P < 0.01) and 0.047 (P < 0.05) respectively, and the absolute value of 10-year increase of systolic pressure in the subjects with abnormal FIB was significantly higher than that in those with normal FIB (P < 0.01). (3) The BP grade 2002 was higher than the baseline grade in 1992 in 49.6% of the study population. The BP grade increase rate of the subjects with abnormal FIB was 55.3%, significantly higher than that of the subjects with normal FIB (46.8%, P < 0.05). (4) In the population without baseline hypertension the risk of BP grade increase within 10 years in those with abnormal FIB was 1.46 times the risk in those with normal FIB, the multivariable OR (95% CI) was 1.457 (1.201 - 1.768) for those with normal BP and 2.082 (1.422 - 3.048) for those with hypertension. CONCLUSIONS Plasma FIB concentration is associated with the BP change. Improvement of high coagulation and high adhesion help control BP, especially in people with hypertension.