OBJECTIVE: The association between high-dose ionizing radiation and the incidence of hypertension is well-established, whereas the impact of low-dose ionizing radiation (<
20 mSv) on hypertension remains uncertain. The aim of this study is to assess the risk of hypertension among petroleum workers workers following long-term exposure to low-dose ionizing radiation (<
20 mSv). METHODS: The study began in July 2013 and was followed up to December 2019. The subjects were petroleum and petrochemical workers in Karamay, Xinjiang (n = 2658). The radiation type is ionizing radiation (X-rays, γ-rays), with a dose range of 0-110.84 mSv. This study identifies hypertension cases based on the "Chinese Guidelines for the Prevention and Treatment of Hypertension". logistic regression is the primary statistical methods employed in this study. RESULTS: Compared with the unexposed group, long-term low-dose ionizing radiation exposure is a risk factor for the incidence of hypertension (RR = 2.09, 95% CI = 1.40-3.06). middle (5.17-20.00 mSv) (RR = 2.70, 95% CI = 1.39-4.99), cutoff (20.00-48.33 mSv) (RR = 3.02, 95% CI = 1.38-6.13) and high cumulative exposure dose (48.33-110.84 mSv) (RR = 3.05, 95% CI = 1.46-5.96) are all associated with the incidence of hypertension, and the risk of hypertension increases with the increase of exposure dose. Low (>
0-5.17 mSv), middle (5.17-20.00 mSv), cutoff (20.00-48.33 mSv)and high cumulative exposure dose (48.33-110.84 mSv) systolic and diastolic blood pressure increase with the increase of cumulative exposure dose (P <
0.05). CONCLUSIONS: This study found that low-dose ionizing radiation (<
20 mSv) is associated with the incidence of hypertension among petroleum workers. The cumulative exposure dose is related to the risk of hypertension in petroleum workers, as well as to their systolic and diastolic blood pressure.