Systemic arterial hypertension is a polygenic disease, including the polymorphisms encoding the gene for the renin angiotensin aldosterone axis. In Ecuador, there are patients who refuse to accept the diagnosis of HT on the grounds that they have no obvious symptoms or assume that folk wisdom treatments can control this pathology. Our hypothesis: "There is a significant relationship between deficient population health care, early diagnosis of HT and adherence to treatment". The sample consisted of 484 subjects, 59.1% were women and 40.9% men. The age distribution: young adult (under 50 years of age) 33.5%, middle adult (between 50 and under 65 years of age) 32.9% and older adult (over 65 years of age) 33.7%. The 25.4% were from the Manta canton, 57% from the rest of Manabí and 17.6% from the rest of Ecuador. Coronary heart disease was present in 15.9%, heart failure in 19.8%, cerebrovascular disease in 3.9% and peripheral artery disease in 5.5%. 13.8% did not adhere to pharmacological treatment, 57.9% to dietary treatment and 65.9% to exercise.