Hypertension remains one of the leading risk factors for cardiovascular morbidity and mortality worldwide. Despite the availability of effective antihypertensive medications, blood pressure control rates remain suboptimal in many populations due to poor medication adherence. Medication adherence is influenced by a complex interaction of patient-related, socioeconomic, healthcare system, therapy-related, and disease-related factors. This study examines the relationship between hypertension control and medication adherence among adults through a comprehensive review of clinical evidence and public health perspectives. The paper explores determinants of adherence, barriers to effective blood pressure management, interventions that improve compliance, and emerging technological solutions. Findings indicate that improved adherence is strongly associated with better blood pressure control, reduced cardiovascular events, decreased healthcare costs, and enhanced quality of life. The study concludes that multidisciplinary approaches combining patient education, digital health technologies, healthcare provider engagement, and policy support are essential for improving hypertension outcomes globally.