Objective: To provide basic information and theories for prehypertension early intervention, a systematic analysis of the epidemic status and risk factors among young and middle-aged was carried out here. Methods: This study relied on the data bank of a health check-up population of a class a tertiary general hospital in Guangdong province in 2015. Total 9540 young and middle-aged adults were enrolled, and 733 people were included to find out the effect with lifestyle in these crowd. Principal Components Analysis (PCA) of Factor (FA) was used to identify dietary patterns. The logistic regression model was used to find the risk factors of prehypertension. Results: Among 9540 young and middle-aged cases, the incidence of prehypertension was 36.6%. Moreover, the average age, proportion of male gender, overweight, FBG (fasting blood glucose), dyslipidemia, and hyperuricemia were significantly higher in the prehypertension group than in the optimal BP group. Multivariate logistic regression analysis indicated that age, total cholesterol, triglycerides, uric acid, body mass index and HR (heart rate) were risk factors, and female was a protective factor for prehypertension. Among 733 cases, the incidence of prehypertension was 35.1%. The proportion of smoking, drinking, physical workers, moderate and severe physical activity, and the intake of meat, dietary energy were significantly higher in the prehypertension group than in the optimal BP group. Dietary patterns included “meat model”, “spice model”, “main vegeTables model” and “high protein model”. Multivariate logistic regression analysis indicated that age, drinking were risk factors for prehypertension, while dietary milk intake, dietary magnesium intake were protective factors. Conclusions: Prehypertension is highly prevalent in Guangzhou. However, education about effective lifestyle modifications as an alcohol limit, increasing the intake of dairy products, and magnesium may intervene in the development of prehypertension. But how to develop targeted interventions for such groups need to be further explored. The present study would lay the theoretical foundation and basic data for the next step.