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Although body weight (BW) and waist circumference (WC) reduction are key goals of Japan's Specific Health Guidance program, limited evidence exists linking these reductions to a lower incidence of hypertension. This study aimed to evaluate the association between changes in BW and WC and the subsequent development of hypertension among men in a nationwide population. We retrospectively analyzed 23,109 men aged 40-64 years who required intensive health guidance and had no prior history of hypertension, using a nationwide database (DeSC Healthcare, Tokyo, Japan) from April 2014 to August 2023. One-year changes in BW and WC were examined for their association with incident hypertension using multivariable Cox regression and cubic spline analyses. During a mean follow-up of 1381 ± 789 days, 4162 men (18.0%) developed hypertension. Greater reductions in BW and WC were associated with a progressively lower risk of hypertension. In multivariable Cox models, BW reductions of ≤ -3.0 kg, -2.9 to -2.0 kg, and -1.9 to -1.0 kg were significantly associated with reduced hypertension risk (HR: 0.74 [95% CI: 0.67-0.82], 0.85 [0.76-0.96], and 0.89 [0.81-0.99], respectively). WC reductions of ≤ -3.0 cm and -2.9 to -2.0 cm were also significantly associated with reduced risk (HR: 0.80 [0.73-0.88] and 0.81 [0.72-0.92], respectively). Cubic spline analyses confirmed a monotonic decrease in hypertension risk with increasing BW and WC reduction. Among men eligible for Specific Health Guidance, one-year reductions in BW and WC were significantly associated with a lower risk of developing hypertension.