Since noncompliance is a major factor in the outcomes of drug therapy for chronic conditions like hypertension, improving compliance improves the outcomes of therapy. Research with hypertensive patients has found more than 50% are noncompliant. Adherence to a medication regimen requires patients to change their behavior. Research on a range of behaviors from smoking cessation to adopting an exercise program has found behavior change is a process and individuals have different readiness to change. OBJECTIVE: Examine how readiness to comply, processes of change, temptations to be noncompliant and patients' views of the pros and cons of compliance are related to self reported compliance. METHODS: Several compliance measures, including a readiness to comply scale, a pros and cons scale, a processes scale and a temptation to skip medication scale were administered to 731 hypertensive patients, who also reported their compliance in the last four weeks. RESULTS: Readiness to comply was highly related to reported compliance (contingency coefficient =.72, p<.0001). As readiness to comply increased, overall level of temptations decreased and patients rated the positive aspects of compliance or the pros higher and the negatives or cons lower and used different processes of change. CONCLUSIONS: Behavior change compliance measures are related to self reported compliance. Utilizing these measures will improve assessment of an individual's readiness to comply and permit creation of customized interventions for individual patients.