Background: Arterial hypertension is a significant health burden in Mexico with limited data to elucidate cardiometabolic profiles.AIMS: We aim to deliver the first insights from the Registry of Arterial Hypertension in Mexico (RIHTA), aiming to characterize the blood pressure goals and prevalence of cardiometabolic risk factors among the hypertensive Mexican population.Methods: A cross-sectional analysis was performed on 5,590 participants between December 2021 and April 2023. The prevalence of controlled and uncontrolled arterial hypertension was assessed using both the 2017 ACC/AHA and 2018 ESC/ESH thresholds, along with a detailed evaluation of eleven cardiometabolic risk factors including overweight, obesity, central obesity, insulin resistance, diabetes, hypercholesterolemia, hypertriglyceridemia, low-HDL-C, high-LDL-C, low-eGFR, and high CVD risk.Results: In a sample of 5,590 participants (female: 61%, n=3,393; median age: 64 [IQR: 56-72] years), the prevalence of uncontrolled hypertension varied significantly, depending on the definition (2017 ACC/AHA: 59.9%, 95% CI: 58.6-61.2 and 2018 ESC/ESH: 20.1%, 95% CI: 78.8-81.0). In the sample, 40.43% exhibited at least 5-6 risk factors, and 32.4% had 3-4 risk factors, chiefly abdominal obesity (83.4%, 95% CI: 82.4-84.4), high-LDL-C (59.6%, 95% CI: 58.3-60.9), high-CVD risk (57.9%, 95% CI: 56.6-59.2), high triglycerides (56.2%, 95% CI: 54.9-57.5), and low-HDL-C (42.2%, 95% CI: 40.9-43.5).Conclusion: There is a high prevalence of uncontrolled hypertension interlinked with a high burden of cardiometabolic comorbidities in Mexican adults living with arterial hypertension, underscoring the urgent need for targeted interventions and better healthcare policies to reduce the burden of the disease in our country.Funding: This work was funded by "Armstrong Laboratorios SA de CV".Declaration of Interest: The authors declare no conflict of interest.Ethical Approval: The medical ethics committee of the Mexican Institute of Social Security approved the protocol. All patients provided verbal informed consent before being registered in RIHTA. The study adhered to the principles of the Declaration of Helsinki and the STROBE guidelines for cross-sectional studies. Confidentiality of patient data was maintained in accordance with Mexican law.