The authors investigated whether a genetic risk score (GRS) constructed of 32 single nucleotide polymorphisms would predict incident hypertension and blood pressure (BP) change over time in a population cohort during an 11-year follow-up (n=5402 at baseline, 3266 at follow-up). In multivariable models, GRS was associated with higher systolic/diastolic BP values at baseline (+/- standard error [SE], 1.04 +/- 0.14/1.11 +/- 0.13 mm Hg; P<.0001 for both) and at reinvestigation (+/- SE, 0.84 +/- 0.18/0.79 +/- 0.16 mm Hg; P<.0001 for both). Among participants who were normotensive at baseline (n=2045), GRS was not independently associated with systolic/diastolic BP change over time (+/- SE, 0.16 +/- 0.18/0.20 +/- 0.18 mm Hg; P.28 for both). In participants in the top tertile of the GRS, as compared with the bottom tertile, the predicted increase in systolic/diastolic BP was 1.18 +/- 0.78/0.70 +/- 0.49 mm Hg (P=.046/.15) greater and the odds ratio for incident hypertension was 33% higher (P=.03). These data show that GRS is strongly associated with BP but weakly associated with BP increase and incident hypertension in a late middle-aged population.