ArticleBMJ global health2017
Quantifying unmet need for hypertension care in South Africa through a care cascade: evidence from the SANHANES, 2011-2012.
Article in BMJ global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05002322 (Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis and Care Cascade for HIV-infected Individuals), which is not on this map. Cited by 91 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis and Care Cascade for HIV-infected Individuals
Who cites it
91 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevalence of obesity, hypertension and diabetes among people living with HIV in South Africa: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis.International journal of public health · 2023Pooled it
- The cascade of care in managing hypertension in the Arab world: a systematic assessment of the evidence on awareness, treatment and control.BMC public health · 2020Pooled it
- Type 2 diabetes in BRICS countries from 1990 to 2023: burden, trends and complementary Mendelian randomization evidence.Endocrine · 2026Article
- Hypertension Prevalence and Associated Risk Factors in a South African Population.International journal of environmental research and public health · 2026Observational
- Integrated Model for Evidence-Based Risk Factor Prioritisation and Dynamic Resource Allocation in Hypertension Prevention and Control: A Study Protocol.Healthcare (Basel, Switzerland) · 2026Article
- Assessing the burden and inequality in the unmet need for hypertension and type 2 diabetes care using a care cascade framework in Tanzania, Lesotho, and South Africa.Primary health care research & development · 2026Article
- Impact of Preeclampsia on Long-Term Kidney Function in a Low-Resourced Setting.Kidney international reports · 2026Article
- Neighborhood deprivation and cardiometabolic risk factors in people living with HIV in urban South Africa.Health & place · 2026Article
- A qualitative study of the social and structural vulnerabilities of HIV and chronic disease syndemics in low-resource urban health facilities in South Africa.Discover public health · 2026Article
- The impact of COVID-19 pandemic on mortality among adults receiving care for chronic health conditions in rural South Africa: findings from Agincourt health and socio-demographic surveillance system.Population health metrics · 2025Article
- Unveiling pathways to enhance hypertension and diabetes care in rural China: a mixed methods study using the care cascade model.The Lancet regional health. Western Pacific · 2025Article
- Self-reported hypertension prevalence, risk factors, and knowledge among South Africans aged 24 to 40 years old.Journal of human hypertension · 2025Article
- High prevalence but lack of awareness of hypertension in South Africa, particularly among men and young adults.Journal of human hypertension · 2025Article
- Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities.Journal of human hypertension · 2025Review
- Hypertension guideline implementation and blood pressure control in Matlosana, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- The impact of health insurance on hypertension care: a household fixed effects study in India.BMC public health · 2024Article
- Material needs security and cardiovascular risk factors in rural South Africa.BMC public health · 2024Observational
- The care cascade of chronic obstructive pulmonary disease in China: a cross-sectional study of individual-level data at enrolment into the national 'Happy Breathing' Programme.EClinicalMedicine · 2024Article
- Understanding barriers and facilitators to integrated HIV and hypertension care in South Africa.Implementation science communications · 2024Article
31 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHypertension has become a major cause of morbidity and premature mortality in South Africa, but population-wide estimates of prevalence and access to care are scarce. Using data from the South African National Health and Nutrition Examination Survey (2011-2012), this analysis evaluates the national prevalence of hypertension and uses a care cascade to examine unmet need for care.
methodsHypertension was defined as blood pressure over 140/90 mm Hg or use of antihypertensive medication. We constructed a hypertension care cascade by decomposing the population with hypertension into five mutually exclusive and exhaustive subcategories: (1) unscreened and undiagnosed, (2) screened but undiagnosed, (3) diagnosed but untreated, (4) treated but uncontrolled and (5) treated and controlled. Multivariable logistic regression models were used to explore factors associated with hypertension prevalence and diagnosis.
resultsIn South Africans aged 15 and above, the age standardised prevalence of hypertension was 35.1%. Among those with hypertension, 48.7% were unscreened and undiagnosed, 23.1% were screened but undiagnosed, 5.8% were diagnosed but untreated, 13.5% were treated but uncontrolled and 8.9% were controlled. The hypertension care cascade demonstrates that 49% of those with hypertension were lost at the screening stage, 50% of those who were screened never received a diagnosis, 23% of those who were diagnosed did not receive treatment and 48% of those who were treated did not reach the threshold for control. Men and older individuals had increased risks of being undiagnosed after controlling for other factors.
conclusionsThere is significant unmet need for hypertension care in South Africa; 91.1% of the hypertensive population was unscreened, undiagnosed, untreated or uncontrolled. Data from this study provide insight into where patients are lost in the hypertension care continuum and serve as a benchmark for evaluating efforts to manage the rising burden of hypertension in South Africa.
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