Hypertension is considered one of the major risk factors for various cardiovascular disorders, including coronary artery disease, congestive heart failure, atrial fibrillation, peripheral arterial disease, and aortic aneurysm. Chronically elevated blood pressure puts more strain on the heart, causing structural and functional changes that are referred to as hypertensive heart disease, these alterations affect the left ventricle, left atrium, and coronary arteries, this is prospective observational study conducted for 6 months; this study found some interesting facts about prescribing pattern of antihypertensives in cardiac patients. Mono therapy antihypertensives are prescribed for denovo hypertension and blood pressure within the targeted range, ACEi and ARBs are the first line drugs in mono therapy and along with these selective beta blockers like metoprolol has been mostly used to prevent cardiac problems, Dual drug therapy is used in uncontrolled hypertensive cases with other co morbidities like CAD, CKD, persistent elevated blood pressure, ARBs with diuretics are the initial choice of drugs later on ARBs with beta blockers, ARBS, CCBs. Triple drug regimen has been prescribed to the patients with uncontrolled persistent blood pressure with other comorbodities like CKD are suggested with clonidine to manage the blood pressure to less than 140mmHg, sacubitril with valsartan, diuretics gave the best results in heart failure cases, digoxine with ARBs, diuretics improved patient condition, these combinational drugs decreased the cardiac associated mortality.