The aim of this study was to investigate the predictive validity of a proposed revision of the Nutri-Score and the current Nutri-Score by investigating associations between the diet quality scores measured in mid-pregnancy and the risk of dispensed prescription of medications for hypertension up to 11 years following delivery and blood pressure mid-pregnancy. The study population (n 70 730) were participants in the Norwegian Mother, Father and Child Cohort Study. Food intake was assessed in mid-pregnancy using a validated FFQ. Nutritional scores for each food item were calculated based on content of energy, sugars, saturated fat, salt, fibre, protein, fruit, vegetables and legumes. Diet quality scores were derived using energy-weighted means of nutritional scores. Anti-hypertensive medications were registered in the national prescription database. We estimated hazard ratios (HRs) with 95 % CIs using Cox regression models. During a mean follow-up of 6 years, 4736 (6·7 %) women were dispensed prescription for medications for hypertension. There was a non-linear association between diet quality and hypertension medication. Compared with the median diet quality score, poorer diet quality (90th percentile of the score) was associated with higher risk of medications for hypertension (HR = 1·08, 95 % CI 1·02, 1·14) and cross-sectional high diastolic blood pressure (OR = 1·18, 95 % CI 1·03, 1·32). Both diet quality scores yielded similar results overall. Poorer diet quality during pregnancy, assessed with a proposed version, and the current Nutri-Score, was associated with a higher risk of medications for hypertension, indicating its usefulness as a valuable tool for guiding consumers and improving public health.