The High Prevalence of High Normal Blood Pressure and the Differential Association of Grip Strength Metrics with Hypertension in a National Sample of Chinese College Students

<b>Background/Objectives</b>: The potential of relative grip strength as a biomarker for cardiovascular risk in college students is not well understood. <b>Methods</b>: Blood pressure status and grip strength metrics were analysed with multivariate logistic regression and restricted cubic spline models, utilising nationwide cross-sectional data from 42,591 Chinese college students. <b>Results:</b> After adjustment, higher absolute grip strength increased hypertension risk (High-level OR = 2.66; 95% CI: 2.21-3.20). In contrast, higher relative grip strength not only reduced risk overall (High-level OR = 0.41; 95% CI: 0.36-0.46) but also demonstrated consistent protective effects across all BMI subgroups (e.g., OR = 0.83 in overweight/obese individuals). <b>Conclusions</b>: Relative grip strength may present a valuable biomarker for cardiovascular risk assessment and the easy identification of at-risk individuals in all BMI categories.