Hypertension increases appreciably cardiovascular risk and has a great public burden worldwide. High hypertension incidence rates are found among middle to elderly aged adults and the risk factors for hypertension incidence included age, gender, obesity, metabolic syndrome and lifestyle factors. Among lifestyle factors, dietary sodium and potassium intakes are associated with blood pressure and hypertension risk in many ecological and cross-sectional studies. For example, a cross-sectional European study showed a linear trend between sodium intake and blood pressure levels. However, the ecological and cross-sectional studies were confounded by various modifying factors and susceptible to bias. Furthermore, geographical and ethnic variations on sodium intake were found. Increasing sodium intake is linked to arterial compliance, fluid intake and associated with platelet activation. Sodium excess is accompanied with other biological mechanism, such as renal excretion defect, and to aggravate the hypertension burdens. Furthermore, increased sodium sensitivity is associated with less renin-angiotensin system activation and increased insulin resistance, and therefore induces increased vasoconstriction and high blood pressure. Information about the role of urinary sodium and potassium excretion on hypertension risk has been relatively rare from the ethnic Chinese community, which actually has the highest sodium intake. Therefore, prospective cohort data based on community participants may provide a valid answer for the relationship between urinary sodium excretion and hypertension risk. We found that 24-hour urinary sodium excretion amounts were significantly associated with the risk of developing hypertension over a median of 7.9 years of follow up. The J-shape relationship was independent of body mass index, diabetes, physical activity and other conventional risk factors and not explained by baseline blood pressure levels. We did not find urinary potassium excretion as a protective factor for hypertension risk.