The correlation of drinking water fluoride and hypertension has been reported in an Iranian national-scale ecologic study (DOI: 10.1007/s12011-011-9054-5). Herein, we examined this hypothesis in Larestan area of Iran in a regional-scale ecologic study. The data of hypertension prevalence by different genders in 2011—numbers of people which have blood pressure higher than 130/85—were obtained from health houses of 36 cities and villages. The annual-mean 2010 data of drinking water fluoride in the corresponding cities or villages were also obtained from another study. Statistically significant negative correlations were found between the annual-mean concentration of drinking water fluoride and hypertension prevalence of females (r = -0.411, p = 0.013) and overall (r = -0.372, p = 0.025). There was no such association for males (r = -0.313, p = 0.063). In conclusion, we found decrease of hypertension prevalence with the increase of drinking water fluoride so that more epidemiological and experimental studies are recommended on this matter with better control of confounding factors.

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