A prospective study on 1,482 adult members of 98 Utah pedigrees was carried out to determine which variables may be associated with an increased risk of hypertension incidence. After an average of 7 years of follow-up, 40 individuals had been placed on antihypertensive medications to lower blood pressure. Baseline study variables included anthropometries, clinical chemistry measurements of blood and urine, socioeconomic and lifestyle variables, and detailed erythrocyte ion transport and concentration measurements. Age (relative risk of 4.28 for a 2 SD difference, p< 0.0001) and baseline systolic and diastolic blood pressures (relative risks of 3.55 and 3.52, respectively, both p< 0.0001) had the strongest associations with hypertension incidence. Controlling for age and baseline blood pressure, the following age-and sex-adjusted variables were associated with an increased risk of future hypertension ( A growing number of variables are being identified in population cross-sectional studies L. or in laboratory studies that are related to mechanisms involved in blood pressure control. Although these studies increase our knowledge of the pathophysiology of blood pressure control, it is important to differentiate between factors that are altered before the actual blood pressure increase and factors that respond to the blood pressure changes. Prospective studies with varying lengths of follow-up have identified variables that seem to be altered in normotensive individuals whose blood pressures fit the clinical definition of "hypertension" during the follow-up period. Some of the