Psychosocial work environments may adversely influence blood pressure, but the benefits of altering these factors and introducing coping resources is unclear. We examined whether changing work stressors and coping resources affect the risk of hypertension and elevated BP. A total of 13,145 workers from the Occupational Health Study of Petroleum Industry Workers were included in this study. A baseline evaluation of work-related stress and coping resources was followed up in all participants after 12 years. The changes in task stressors and coping resources were measured using the Occupation Stress Inventory-Revised Edition, and changes in job control and organizational stressors were evaluated using the Instrument for Stress-Related Job Analysis (v. 6.0). Elevated hypertension incidence and BP were associated with increased task and organizational stressors, together with decreased job control and reduced coping resources. Gender-specific differences were observed in the factors influencing BP. The main risk factor was decreased self-care in males (3.11 mm Hg) and increased responsibility in females (2.84 mm Hg). The present study demonstrated that promoting such factors at the task-, individual-, and organizational level may help improve cardiovascular health.