Objective To investigate the blood pressure change in relation to the evolution of impaired glucose tolerance (IGT). Methods From 1986 to 1992, 334 subjects with IGT were randomized to placebo, diet, exercise and diet plus exercise intervention groups. No anti-hypertension drug was given to these enrolled subjects. Blood pressure was measured at the beginning and the end of the six-year prospective study. In this analysis these subjects were stratified to seven subgroups based on 2 h plasma glucose (2hPG) level during OGTT at the end of the study: < 7.8,7.8~8.8,8.9~9.9,10.0~11.0,11.1~13.8,13.9~16.6 and≥16.7mmol/L. Blood pressure changes in relation to the evolution of glucose tolerance in these subgroups were compared by least square mean procedure. Results Changes of systolic blood pressure (SBP) in average in these seven groups were -2.4,0.6,7.7,4.3,1.7,-2.9and-6.9mm Hg (1mm Hg=0.133kPa), and changes of diastolic blood pressure (DBP) were-3.2,3.0,3.3,1.7,-0.7,-1.3 and-3.7mm Hg respectively after controlling for age, sex, BMI at baseline and Δ BMI during the follow-up period. In those subjects with IGT evolved into normal glucose tolerance (NGT) or diabetes, reductions in SBP and DBP were significantly greater than those who retained IGT with 2hPG between 8.9-9.9mmol/L (all P < 0.05 ). In 264 out of the 334 subjects with IGT and blood pressure≥130/80mm Hg at baseline, blood pressure changed more strikingly: changes of SBP in these groups were-5.2,-2.6,5.2,2.3,-2.3,-4.2,-7.6mm Hg, and DBP were -5.0, -3.7,1.5, -2.9, -4.3, - 4.0 and-6.0mm Hg respectively after the adjustment of age, sex, BMI, BMI variation. The reductions of SBP and DBP in subjects whose status of IGT was converted to NGT or diabetes were significantly greater than those with retained IGT and 2hPG between 8.9-9.9mmol/L. Conclusion Blood pressure is increased in the subjects with IGT who retained in the IGT group during the six-year follow-up period in Da-Qing Study. On the contrary, subjects with IGT evolved into NGT or diabetes demonstrate significant reduction of blood pressure.