Abstract: ObjectiveTo investigate the current status of maximal handgrip strength in school-aged children and its correlation with blood pressure, thereby enriching the evidence on the relationship between muscular health and cardiometabolic factors in children. MethodsIn November 2023, a cluster random sampling method was used to measure height, body weight, waist circumference, handgrip strength, and blood pressure among 1,242 primary school students aged 7 to 13 in Shiyan City, Hubei Province. Descriptive statistics were used to assess the current status of maximal handgrip strength in children. Pearson correlation analysis was conducted to examine the relationship between handgrip strength and blood pressure, and binary logistic regression was used to analyze the association between handgrip strength and elevated blood pressure. ResultsHandgrip strength was positively correlated with blood pressure among boys and girls aged 7 to 13 years （all P < 0.05）. The children were categorized into overweight/obese group and non-overweight/obese group based on body weight criteria. In both boys and girls, handgrip strength was significantly higher in the overweight/obese group compared to the non-overweight/obese group （P < 0.001）. Logistic regression analysis showed a positive correlation between handgrip strength and the risk of elevated blood pressure in boys after adjusting for age, body mass index, and waist circumference （P < 0.05）, while no significant association was observed in girls. ConclusionHandgrip strength was positively correlated with blood pressure in school-age children. Increased handgrip strength was associated with an increased risk of hypertension in boys, whereas no such association was observed in girls, suggesting a potential gender difference in the association between musclar strength and cardiovascular health.