Objective: To characterize adherence to pharmacological medication and beliefs towards medication in a group of patients with hypertension in a large national hospital. Copyright: Objective: To characterize adherence to pharmacological medication and beliefs towards medication in a group of patients with hypertension in a large national hospital. Copyright: Materials and Methods: Cross-sectional survey among patients with hypertension attending the outpatient clinic of a large national hospital. Exposure of interest was the patient's beliefs towards general medication and antihypertensive drugs, i.e. beliefs of harm, overuse, necessity and concern, measured using the Beliefs about Medication questionnaire. Main outcome was adherence measured using the Morisky Medication Adherence Scale-8. Multivariate analysis was conducted using Poisson distribution logistic regression, prevalence ratios and 95% confidence intervals were calculated. Results: Data from 115 participants, 67% females and mean age 62.7 years were analyzed. Low adherence was found in 57.4%. Highest scores were on the ideas of necessity and one of the most rated statements was "physicians would prescribe less medication if they spent more time with patients". Beliefs of harm about medications and concerns about antihypertensive drugs were higher in the low adherence group (p[removed] Conclusions: Low adherence to antihypertensive medication is common. High scores on ideas of harm, concern and a high necessity-concern differential were predictors of medication adherence. © 2014 Fernandez-Arias et al.