Hypertension contributes largely to the global burden of disease and mortality. Environmental exposure to metals might be a causative factor for hypertension, but the association remains unclear. The present casecontrol study of 502 hypertension patients and 502 healthy participants aimed to evaluate the potential relationships between the concentrations of 20 metal in urine and the risk of hypertension in a Chinese population. Multivariate logistic analyses adjusted for potential confounders were performed separately considering the effects of single and multi-metal. We found the increasing trends of urinary Fe, Co, Ni, Cu, Zn and Sr quartiles and the decreasing trends of urinary V and Rb quartileswith the ORs for hypertension. These dose-response associations were confirmed in the RCS models and remained robust in the multi-metalmodel. Urinary Hg quartiles were positively associated with the risk of hypertension in the models of single-metal and multi-metal. Urinary Cd quartiles were inversely associated with the risk of hypertension in the multi-metal model. Besides, modification effects of gender, BMI and smoking status on the associations of the exposure to various metals with the risk of hypertension were also suggested in the subgroup analysis. Our findings suggest that environmental exposure to V, Fe, Co, Ni, Cu, Zn, Rb, Sr, Cd and Hg might be related with the prevalence of hypertension. Further studies with prospective design should be conducted to confirm these findings. (C) 2017 Elsevier B.V. All rights reserved.