Poor blood pressure control and hypertension related complication related to lack of adherence to treatment. Increased pill burden was directly associated with reduced treatment adherence and resistance with antihypertensive therapies in real-practical settings. The hypertensive patients with pill burdens were non-compliance to their appointment follow-up in the hypertensive follow-up. The possible cause for this poor adherence follows up and noncompliance for anti-hypertension medication may be drug side effect, drug- drug interactions and health expenditure.