<![CDATA[Hypertension remains a major public health problem because it requires long-term therapy, risk-factor control, and sustained medication adherence, while patients in urban primary care frequently experience difficulties in understanding health information. This study aimed to examine the relationship between health literacy and medication adherence among patients with hypertension in urban community health centers. An analytic observational study with a cross-sectional design was conducted among 214 hypertensive patients receiving routine care at three urban primary health centers. Data were collected using a respondent characteristics form, a validated and reliable health literacy instrument, and an antihypertensive medication adherence scale. Data were analyzed using chi-square tests and multivariable logistic regression. The findings showed that 57.9% of respondents had limited health literacy and 46.3% had low medication adherence. Patients with adequate health literacy were more likely to adhere to antihypertensive medication than those with limited health literacy (AOR = 2.41; 95% CI: 1.36–4.27; p = 0.002) after controlling for age, education, duration of hypertension, and comorbidity. This article argues that health literacy is a modifiable determinant of medication adherence in hypertension management at the primary care level. The study contributes empirical evidence for strengthening health communication interventions, simplifying medication information, and designing literacy-sensitive patient education strategies in urban primary care settings.]]>
