Aim To explore the predictive value of cumulative blood pressure exposure (cumBP) for new-onset atrial fibrillation (AF). Methods A prospective cohort study was used in this study. The people of Kailuan Group, Tangshan, were observed every two years since 2006. By the end of 2015, five examinations were carried out. The number of participants in the first three physical examinations with complete blood pressure and other baseline data was 57927. 40727 subjects were included in the final statistical analysis, excluding the patients with previous AF history and missing electrocardiogram data during follow-up. According to cumulative systolic blood pressure exposure (cumSBP), four quantiles grouping was performed:first quartile group:cumSBP＜464 mmHg·year; second quartile group:464 mmHg·year≤cumSBP＜512 mmHg·year; third quartile group:512 mmHg·year≤cumSBP＜569 mmHg·year; fourth quartile group:cumSBP≥569 mmHg·year. The status of new-onset AF was compared in different cumSBP groups. COX proportional hazard model was used to analyze the predictive value of cumBP for new-onset AF. Results (1)In 40727 cases, the average age was 51.81±11.54 years old, among them, there were 30693 males (75.4%) and 10034 females (24.6%). (2)The results showed that the proportion of men and the levels of age, body mass index, fasting blood glucose, total cholesterol and uric acid increased with the increase of cumSBP, and the differences among the groups were statistically significant (P＜0.05). (3)The average follow-up period was 4.97±0.37 years. The analysis of the multivariate COX proportional hazard model affecting the new-onset AF showed that, after correcting other confounding factors, the HR value of new-onset AF was 1.034 (95%CI 1.012-1.057) for every 10 mmHg·year increase in cumSBP, and HR value was 1.026 (95%CI 1.008-1.044) for every 5 mmHg·year increase in cumulative diastolic pressure exposure. Conclusion Cumulative blood pressure exposure has predictive value for new-onset atrial fibrillation.