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High blood pressure leads to greater risk of cardiovascular disease morbidity and mortality. Our aim was to determine the prevalence of hypertension in a cohort of people attending a rural university health screening program in response to community advertisements. In all, 674 individuals attended the screening program at our university health clinic in Albury. The presence and treatment of diagnosed hypertension were reported by 37.3% of participants. Antihypertensive medications were used in 42.9% of the known hypertensives, and fewer than half of these patients on antihypertensive agents achieved a normal blood pressure. New hypertension in accordance with the AusDiab criteria that is not diagnosed and treated was identified in 20.8% of participants. We conclude that the rates of antihypertensive treatment were low in this rural population, and that in those who were treated, a large portion still remained hypertensive. The management and monitoring of hypertension in this rural community needs to be improved to capture the additional people with hypertension and to reduce blood pressure to recommended levels.