Objective: To explore the effect of health management model based on disease risk stratification on young and middle-aged patients with prehypertension. Methods: A total of 256 young and middle-aged patients with prehypertension were randomly divided into observation group and control group with 128 cases in each group. The control group received routine health education, while the observation group received health management model based on disease risk stratification. Results: After 6 months of intervention, the levels of overweight, obesity, excessive salt intake, insufficient exercise, unreasonable diet， and drinking in the observation group were lower than the control group（ P<0.05）. There was no significant difference between smoking and psychological problems( P>0.05). There was significant difference between unreasonable diet and drinking in the trend test （P<0.05）.After 3 and 6 months intervention， the scores of self-health management behaviors in the observation group were significantly higher than those in the control group（ P<0.05）， and it tended to increase with time（ P<0.001）.The levels of SBP and DBP in the observation group were significantly lower than those in the control group， and it tended to decrease with time（ P<0.001）. Conclusion: The health management model based on disease risk stratification can effectively decrease the health risk factors for young and middle-aged patients with prehypertension and promote self-health management of the patients, so as to control blood pressure effectively.