The control rates of patients with hypertension remain extremely low in Chinese rural communities, therefor we aimed to improve treatment adherence and control rate for patients with hypertension by using a web-based management system, which included modeles of the user’s personal information, health education, adherence alerting, communication between physician and statistics analysis and data print functions. 350 patients with uncontrolled hypertension were included in the study through a multi-stage stratified sampling, and were divided radomis1y into the web-based intervention group and control group. Comparing with those in the control group, there was a significant improvement in the control rate of the blood pressure in the intervention group (93.7% vs 50.9%, p < 0.001) and a remarkable decrease in blood pressure (systolic blood pressure declined by 25.0 mmHg, < 0.001; diastolic blood pressure declined by 8.7 mmHg, p < 0.001) after 12 months follow-up. The medication adherence rate in intervention groups was improved significantly than that in the control group p < 0.01)，and the adherence scale correlated negatively with blood pressure (r=-0.518, P < 0.001), and positively correlated with control rate (0.623, P < 0.001). This study suggested that the web-based hypertension management system is worth spreading in rural areas in developing countries.