We assessed and evaluated drug compliance and the factors militating against good compliance in 68 hypertensive Nigerians with and without heart failure. Of our patients who were detected to have high blood pressure for some years previously, 59.5% were not informed by their physicians of the need for continued and regular treatment and follow-up; 21.6% were informed but could not keep to regular medication and follow up purely due to economic constraints; 18.9% were informed and yet did not keep to regular medication due to reasons such as alternative medical treatment, frustrations with daily ingestion of drugs, or a feeling of well-being. Drug compliance was poor in all socio-economic classes. Following intervention through health education on the consequences of poorly managed hypertension, and the involvement of the Medical Social Workers in the management of defaulters, the drug compliance markedly improved. The results show that ignorance seems to be the major factor militating against proper control of blood pressure in our hypertensives, and not economic constraint.