Background Patient related factors hindering optimal blood pressure (BP) control in patients with hypertension are unclear.ObjectivesTo investigate the barriers to optimal hypertension management. MethodsA survey on the awareness and management of hypertension was conducted in 556 patients (365 males, mean age 60.9 Ã‚± 10.1) from a rural community.Results Of the 556 patients who had a clinical diagnosis of hypertension, 127 (22.8%) were unaware the existence of the condition and received no therapy. In the 429 patients who were aware the presence of hypertension, 206 (48.0%) did not receive any antihypertensive medication at the time of this study. Fifty-four (12.5%) had a BP of less than 140/90 mm Hg. Only 21 (4.9%) received formal counselling or education from health professionals and 74 (17.2%) were aware of the optimal level of BP. Difficulty in accessing a specialist doctor was reported by 126 (29.4%). In 279 (65.0%), missing regular anti hypertensive medications was reported in the 4-week period prior to this study. Omitting prescribed antihypertensive drugs due to the costs was reported by 169 (39.4%).Conclusion Inadequate counselling, lack of understanding on the disease, difficulties in accessing specialist care and poor medication adherence are the barriers to optimal BP control.