Associations between self-management and biopsychosocial variables in a group of Afrikaans- (n= 102) and Sotho-speaking (n= 94) patients with essential hypertension (EH) were investigated. Self-management in terms of predetermined criteria for medical and lifestyle prescriptions was achieved by only 30.6 per cent of the participants. Significant differences were found between self-managing and non self-managing participants regarding language and culture, doctor-patient fit, complexity of prescriptions, medication side-effects, aspects of health beliefs, illness behaviour and health locus of control. In addition, a first empirical indication was found that self-management is also linked with psychological wellbeing, as manifested in a sense of coherence. The significantly accurate prediction of self-management by various biopsychosocial variables endorses the relevance of a biopsychosocial perspective in the treatment of patients with EH.