The overall level of adherence to antihypertensive medications was 59.94% (95% CI: 54.65-65.06). Urban residence (AOR = 1.96; 95% CI: 1.21-3.18), college and higher education level (AOR = 3.41; 95% CI: 1.69-6.87), health insurance coverage user (AOR = 2.00; 95% CI: 1.11-3.59), having knowledge about hypertension (AOR = 1.75; 95% CI: 1.03-2.97), distance to health care facility less than 10 kilometers (AOR = 4.6; 95% CI: 1.97-10.73), having social support (AOR = 1.86; 95% CI: 1.13-3.08), and taking three and above medications (AOR = 0.28; 95% CI: 0.12-0.64) showed a statistically significant association with medication adherence.