Hypertension has been a leading cause of premature deaths worldwide and it is more prominent in low and middle-income countries and rising. Proper diagnosis and management of hypertension can reduce complications and disability. A new protocol to manage hypertension in primary medical care centers was introduced by American Heart Association to reduce the cost of treatment while managing the patients properly. It was introduced in PMCs of Kalutara district in Sri Lanka with the help of the Resolve to save lives organization. This clinical audit was conducted in 3 PMCs with 163 participants to identify lapses before scaling up the project to more PMCs. It was found that the mean time taken from the first BP measurement to the second measurement in the 140-159/90-99mmHg group (Group A) was 1.07 weeks (SD=2.04 weeks) while the protocol requires measuring the second value between 2 to 4 weeks. Out of basic investigations, FBS and Serum Cholesterol levels were done in 56.4% and 38% of the participants respectively while ECG and UFRs completed in the study were very less. Further, 55.4% (n=87) of the participants aged 80 years or less were managed with 2 drugs according to the protocol while only 20% (n=1) of the patients aged more than 80 years were managed with 1 drug according to the protocol. Only 22 (45.8%) out of 48 participants who required stepping up of drug management was correctly done. Furthermore, the variation between the 3 hospitals in results was, considerable. The requirement of training for healthcare workers in PMCs to standardise the management was emphasized while the resource allocation for laboratory services for investigations was highlighted after the study.