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BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hyper-tension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(rAI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were in-cluded in our analysis.Baseline rAI normalized to heart rate of 75 beats/min(rAIp75)was obtained using HEM-9000AI.New-on-set hypertension was defined as blood pressure 2140/90 mmHg or self-reported hypertension or taking anti-hypertensive medic-ations at the follow up survey.Multivariate regression models were used to evaluate the impact of rAIp75 on the risk of new-on-set hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19％)participants developed incident hypertension.No significant relation between rAIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(ad-justed odds ratio(OR)and 95％confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,rAIp75 was significantly associ-ated with incident hypertension in women,but not in men(adjusted OR and 95％CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;Pfor interaction=0.0133).CONCLUSIONS Sex modified the effect of the rAI on incident hypertension in a Chinese,community-based,non-hypertens-ive population.Screening of the rAI could be considered in women with a high risk of hypertension for the purpose of primary intervention.