Hypertension is a major modifiable risk factor for cardiovascular disease and a leading cause of morbidity and mortality worldwide. Despite the availability of effective treatments and clinical guidelines, poor patient adherence remains a significant barrier to optimal blood pressure control. The International Society of Hypertension (ISH) 2020 guidelines emphasize a comprehensive approach to hypertension management, including pharmacological treatment, lifestyle modifications, and regular monitoring. This study aimed to assess adherence to hypertension management practices based on ISH 2020 guidelines and identify factors influencing adherence among patients at a tertiary care teaching hospital. A questionnaire-based cross-sectional study was conducted among hypertensive patients admitted to inpatient services. A structured questionnaire was used to evaluate medication adherence, lifestyle modifications, and follow-up visit frequency. Demographic characteristics, knowledge of hypertension, and healthcare accessibility were also assessed. Descriptive statistics and logistic regression analysis were used to determine adherence patterns and associated factors. Out of 123 participants, 74.8% adhered to prescribed antihypertensive medication, while 67.5% maintained long-term adherence. Dietary adherence was high, with 71.5% following a low-salt diet and 78.9% increasing vegetable intake. However, adherence to exercise (39%) and stimulant/alcohol reduction (27.6%–54.5%) was lower. Overall, knowledge and consistent follow-up were associated with better adherence. The findings underscore the need for targeted interventions such as patient education, access to affordable medications, and adherence monitoring. Implementing hospital-based strategies in alignment with ISH 2020 guidelines can enhance adherence and improve hypertension outcomes.
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