Background <p>Hypertension is a leading cause of cardiovascular morbidity and premature mortality worldwide. Limited access to specialist care in rural areas contributes to suboptimal blood pressure control and persistent healthcare disparities. Telemedicine offers a potential solution to bridge this gap.</p> Methods <p>This retrospective observational study assessed the feasibility of WhatsApp-based teleconsultations for managing arterial hypertension in rural Kazakhstan. The intervention was conducted in three remote villages served by a district medical center. Patients with uncontrolled hypertension or cardiovascular symptoms were referred for remote cardiology consultations via WhatsApp, integrated with the national electronic health record system. Data on clinical decisions, treatment modifications, and patient self-monitoring behaviors were analyzed. A patient satisfaction survey was conducted between September and December 2024.</p> Results <p>A total of 78 patients with arterial hypertension were included. Most consultations were conducted at patients’ homes using smartphones. Stage 3 hypertension was observed in 63% of participants. Treatment adjustments were made in 73.1% of cases following teleconsultation. Gender differences were identified in self-monitoring practices, with women more likely to perform regular home blood pressure monitoring. Among 54 respondents, 82% reported convenience of teleconsultations, and 63% expressed high satisfaction with the quality of care.</p> Conclusions <p>Mobile-based teleconsultation using widely available messaging platforms is a feasible and acceptable approach that may improve access to specialist care. This model demonstrates potential for integration into primary healthcare systems to support hypertension management in resource-limited environments. Further studies are needed to evaluate clinical outcomes and long-term effectiveness.</p> Trial registration <p>Not applicable.</p>