Introduction: Hypertension represents one of the leading causes of morbidity and mortality worldwide. Lack of adherence to antihypertensive pharmacological treatment remains a significant issue, especially in regions with geographic and cultural limitations such as Loreto, Peru. This study aimed to determine the factors associated with adherence to pharmacological treatment among hypertensive patients attending three primary healthcare facilities in Iquitos, 2025. Methods: An observational, analytical, cross-sectional study was conducted among 340 hypertensive patients selected through stratified random sampling. The Morisky Green questionnaire was used to assess treatment adherence. Sociodemographic, clinical, and therapeutic variables were analyzed using Chi-square and Mann Whitney U tests, considering a significance level of p<0.05. Results: The median age was 64 years, 77.1% were wom...