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Despite an increasing popularity of home blood pressure monitoring (HBPM) over the last few decades, little is known about HBPM use among hypertensive patients in the rural areas. A cross-sectional survey including 318 hypertensive patients was conducted in a rural community in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed the questionnaires assessing HBPM usage. Binary logistic regression models were used for the analysis of medication adherence with age, gender, level of education marital status, perceived health status, duration of hypertension, HBPM use, and frequency of performing BP measurement. Among the total population, 78 (24.5%) reported currently use of HBPM. Only 5.1% of the HBPM users cited doctor’s advice as the reason for using HBPM. Analysis of the risk factors of poor medication adherence by multivariable modeling indicated significant associations between the duration of hypertension (adjusted OR, 3.31; 95% CI, 1.91-5.72; P < 0.001), frequency of performing BP measurements (adjusted OR, 2.33; 95% CI, 1.42-3.83; P < 0.001) and medication adherence. We found that most use of HBPM was without the involvement of a doctor or nurse. Further study is required to understand if HBPM is effective and the role of health professionals in its use for improved hypertension control.