The sex- and age-specific relation in the association of resting heart rate (RHR) and its change and risk of hypertension remains unclear. We prospectively estimated the incidence of hypertension among 9969 nonhypertensive adults participating in The Rural Chinese Cohort Study. Self-reported questionnaires and anthropometric and laboratory measurements were collected at baseline (2007-2008) and follow-up (2013-2014). The modified Poisson regression model was used to calculate relative risk (RR) values and 95% confidence intervals (CIs) for incident hypertension associated with RHR and its dynamic change. During follow-up (median, 6.01 years), 797 (20.28%) men, and 1178 (19.51%) women developed hypertension. Risk of hypertension was increased for women with the highest versus lowest RHR tertile after adjusting for confounding factors (RR: 1.19 [95%CI: 1.04-1.36]) and was associated with increased RHR for women with young age (RR per 10-beat/min RHR increase, 1.25 [95%CI: 1.09-1.43]), middle age (1.06 [0.99-1.14]), and older age (1.11 [1.01-1.23]). Risk of developing hypertension was significantly higher (RR: 1.22 [95%CI: 1.04-1.42]) in women with high RHR (≥80-beat/min) throughout the study period than those with normal RHR (<80-beat/min). No significant association of RHR and hypertension was found in men. RHR is an independent predictor of hypertension in rural Chinese women. Persistently high RHR is associated with increased hypertension risk in women. The dose-response association between RHR and hypertension could be affected by sex and age status.