OBJECTIVES: Patients with hypertension in Japan report poor health outcomes, particularly quality of life.  Although quality of life can be improved with advances in treatment, there are other modifiable factors which could also be examined as potential targets for intervention.  This study investigated the association of medication adherence and health behaviors with health status.   METHODS: Data from the Japan 2012 National Health and Wellness Survey (NHWS) were used (N=30,000).  Only respondents taking a medication for their hypertension were included (n=3,611).  Smoking status, exercise behavior, obesity (measured using body mass index), alcohol use, and medication adherence (measured using the Morisky Medication Adherence Scale [MMAS-8]) were used as predictors of health status (measured using the Short Form-36v2) controlling for demographics and comorbidities. RESULTS: A total of 67.2% respondents were male; the mean age was 63.11 years.   Most patients had a history of smoking (19.6% were current smokers and 36.7% were former smokers) and nearly 30% consumed alcohol daily.  On average, patients exercised less than 7 days per month and a third of patients were either overweight (27.6%) or obese (5.8%). When examining items of the MMAS-8, forgetfulness was the most common reason for non-adherence (forgetting, 47.8%; difficulty remembering, 28.9%; forgetting when traveling/leaving home, 20.7%).  Controlling for demographics and comorbidities, the strongest predictors of health status were with obesity (b = -2.68 for PCS), exercise (b = 0.14 for PCS), and forgetting medications (-1.08 for PCS) (all p<.05). CONCLUSIONS: Significant associations between adherence and health behaviors and health status were observed.  Although cross-sectional associations may not translate to causal relationships, these results suggest that improved exercise and weight reduction may result in notable health status improvements, aside from their well-known clinical benefits.  Interventions which make it easier for patients to remember their medications could also have health status benefits.