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A significant relationship exists between elevated uric acid concentration and both prevalent and incident hypertension; however, data regarding the influence of higher uric acid concentration at baseline on blood pressure control by antihypertensive drugs is scarce. Thus, a prospective cohort study was performed. The study outcome was the non-attainment of optimal blood pressure (NOBP). NOBP level was defined according to the Japanese hypertension guideline. This study enrolled a Japanese community-based cohort (N = 8,664; age 65.5 ± 6.4 years; women, 55.0%) who were not using antihypertensive drugs on the first visit for a health check-up program but started using antihypertensive drug(s) on the next-year visit. The participants were classified into quartiles based basic uric acid concentration. Odds ratios (ORs) were calculated for NOBP as the primary outcome measure. Multivariable logistic analysis showed that quartile 4 was significantly associated with NOBP when quartile 1 was set as the reference (OR (95% confidence interval), 1.36 (1.16-1.59), p<0.01), adjusted for potential confounders, such as age, sex, body mass index, presence of diabetes/dyslipidemia/chronic kidney disease (CKD), history of cardiovascular disease, daily drinking, and current smoking. In the subgroup analysis of female participants and participants with diabetes and CKD, a significant association was observed between +1 mg/dL of uric acid and NOBP. Higher uric acid concentration at baseline was significantly associated with NOBP on the first use of antihypertensive drug(s).