Recent studies have reported that hopelessness is an important factor in cardiovascular morbidity and mortality, including ischemic heart disease, acute myocardial infarction, and atherosclerotic progression. This study examined the relationship between hopelessness and incident hypertension in a population-based sample of 616 initially normotensive, middle-aged men from eastern Finland, an area with high rates of cardiovascular disease. Participants completed a medical examination and a series of psychological questionnaires at baseline and at the 4-year follow-up. Hopelessness was measured by 2 items assessing negative expectancy about the future and one's goals. A logistic regression model with adjustments for age, body mass index, baseline resting blood pressure, physical activity, smoking, alcohol consumption, education, parental history of hypertension, and self-reported depressive symptoms revealed that men reporting high levels of hopelessness at baseline were 3 times more Likely to become hypertensive (systolic blood pressure greater than or equal to 165 mm Hg and/or a diastolic blood pressure greater than or equal to 95 mm Hg or confirmed use of antihypertensive medication) in the intervening 4 years than men who were not hopeless (odds ratio, 3.22; 95% confidence interval, 1.56, 6.67). Men reporting moderate levels of hopelessness were not at a significantly increased risk of hypertension (odds ratio, 1.27; 95% confidence interval, 0.79, 2.07), This is the first study to identify a significant relationship between hopelessness and incident hypertension. Research is needed to explore the neuroendocrine and central nervous system mechanisms underlying this association.