Hypertension remains a leading noncommunicable disease in sub-Saharan Africa, with poor control rates in rural areas. This study evaluated the influence of income, education, and access to care on hypertension management among 2,100 adults in Kenya, Tanzania, and Uganda. Only 37% achieved optimal blood pressure control. Multivariate analysis showed that higher education and stable income significantly predicted treatment adherence (p < 0.01). Community-based interventions targeting socioeconomic disparities may enhance chronic disease management in low-resource settings.