Background: Blood pressure (BP) measurement adherence and medication adherence are essential for effective hypertension (HTN) management, particularly in patients with ischemic heart disease. Despite their importance, adherence to these practices remains suboptimal. Methods: We conducted a randomized, prospective double-blind control trial to evaluate the impact of video assisted education on the improvement of home BP measurement (HBPM) and medication adherence in HTN patients with ischemic heart disease. Patients were randomly assigned in a 1:1 ratio to receive either video-based education, or standard education. The co-primary outcomes were HBPM adherence and HTN medication adherence evaluated at 1 month after randomization. The secondary outcomes included changes in office systolic BP (SBP) and diastolic BP (DBP) from baseline to 1-month follow-up and difference of average SBP and DBP between HBPM and 24-hr ambulatory BP measurement (ABPM) between groups. Results: A total of 217 patients were enrolled, with 107 patients randomly assigned to the video-based education group and 110 to the control group. The video-based education group showed numerically higher adherence to HBPM (88.8% vs. 84.7%, p = 0.217) and significantly higher adherence to HTN medication (99.7% vs. 99.1%, p = 0.035) compared to the control group. Optimal medication adherence was significantly more observed in video-based education group (96.3% vs. 83.6%, p=0.002). Non-compliance to the HBPM was significantly lower in the video-based education group (4.7% vs. 12.7%, p=0.036). Changes in office blood pressure from baseline to 1 month were not significantly different between the groups ( p =NS). No significant differences were observed between 24-hour ABPM and home BP in either group (p=NS). Conclusions: Video-based education improved HBPM adherence and HTN medication adherence in patients with ischemic heart disease and HTN.