Evidence mapPaperPMID 41760346Full record

ArticleBMJ global health2026

Untreated, uncontrolled and below-target hypertension in southern Africa: a population-based prevalence and care cascade assessment in rural Lesotho.

Iliana M Esquivel-Valdés, Giuliana Sanchez-Samaniego, Ravi Gupta, Thesar Tahirsylaj, Fabian Raeber, Mamakhala Chitja, Malebona Mathulise, Thuso Kabi, Mosoetsi Mokaeane, Malehloa Maphenchane and 15 more

Registry-linked trialAbstract read
In one paragraph

Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05596773 (Community-Based Chronic Disease Care in Rural Lesotho), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT05596773 recruitingnot on this map

Community-Based Chronic Disease Care in Rural Lesotho: The ComBaCaL Cohort Study

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2023 to 2027Enrolled17,500ConditionsNon-communicable Diseases (NCDs)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Iliana M Esquivel-ValdésDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0009-0006-5746-713X
Giuliana Sanchez-SamaniegoDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Ravi GuptaSolidarMed Lesotho, Maseru, Lesotho.
Thesar TahirsylajDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Fabian RaeberDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Mamakhala ChitjaSolidarMed Lesotho, Maseru, Lesotho.
Malebona MathuliseSolidarMed Lesotho, Maseru, Lesotho.
Thuso KabiSolidarMed Lesotho, Maseru, Lesotho.
Mosoetsi MokaeaneSolidarMed Lesotho, Maseru, Lesotho.
Malehloa MaphenchaneSolidarMed Lesotho, Maseru, Lesotho.
Molulela ManthabisengSolidarMed Lesotho, Maseru, Lesotho.
Makhebe KhomolishoeleSolidarMed Lesotho, Maseru, Lesotho.
Mota MotaSolidarMed Lesotho, Maseru, Lesotho.
Sesale MasikeSolidarMed Lesotho, Maseru, Lesotho.
Matumaole BaneSolidarMed Lesotho, Maseru, Lesotho.
Mamoronts'sane P SematleSolidarMed Lesotho, Maseru, Lesotho.
Retselisitsoe MakabatengSolidarMed Lesotho, Maseru, Lesotho.
Lebohang SaoMinistry of Health Lesotho, Maseru, Lesotho.
Mosa TlahaniMinistry of Health Lesotho, Maseru, Lesotho.
Pauline GrimmSolidarMed Switzerland, Lucerne, Switzerland.
Thilo BurkardDepartment of Cardiology, University Hospital Basel, Basel, Switzerland.
Frédérique ChammartinDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0001-8959-2724
Alain AmstutzDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-1716-993X
Felix Gerber *Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland felix.gerber@usb.ch.ORCID http://orcid.org/0000-0002-9736-1907
Niklaus Daniel Labhardt *Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHypertension programmes have expanded substantially in low-income and middle-income countries, yet treatment and control rates remain insufficient. Programme scale-up may lead to suboptimal health outcomes and resource allocation if diagnostic accuracy, monitoring and treatment protocol adherence are inadequate. This study aimed to estimate the prevalence of untreated, uncontrolled and below-target hypertension in rural Lesotho, and to identify factors associated with each condition.

methodsWe conducted a population-based cross-sectional study nested within the Community-Based Chronic Care Lesotho (ComBaCaL) cohort study (NCT05596773). Adult cohort participants ≥18 years were eligible for home-based standardised blood pressure (BP) measurement. Hypertension was defined by averaged elevated BP measurements or current use of antihypertensive medication. Uncontrolled hypertension was defined as on-treatment BP ≥140/90 mm Hg, and below-target hypertension as on-treatment systolic BP <110 mm Hg. Multivariate regression models were conducted to identify associated factors.

resultsBetween 8 September 2023 and 10 February 2025, 8236 adult participants were screened, with 18.3% (n=1505) diagnosed with hypertension. Of those diagnosed, 75.1% (n=1130) were on treatment and 24.9% (n=375) untreated. Among those on treatment, 53.5% (n=605) were controlled, 26.3% uncontrolled (n=297) and 20.2% (n=228) below target. Female sex, age ≥65 years, diabetes and a history of stroke or myocardial infarction were associated with lower odds of being untreated, while smoking and alcohol consumption increased these odds. Taking ≥3 antihypertensive drugs and non-adherence were associated with a higher risk of uncontrolled hypertension. Dual antihypertensive therapy was associated with a lower risk of being below target, while a history of stroke or myocardial infarction increased this risk.

conclusionsDespite higher-than-expected hypertension treatment and control rates, substantial gaps remain, including untreated, uncontrolled and below-target hypertension, underscoring the need to strengthen diagnostic accuracy, monitoring and adherence to treatment protocols, with particular attention to high-risk groups.

Indexed as

Antihypertensive AgentsHypertensionRural PopulationAdultAgedCross-Sectional StudiesFemaleHumansLesothoMaleMiddle AgedPrevalenceRisk FactorsUndertreatmentAntihypertensive AgentsAfrica South of the SaharaHypertensionTreatment

Identifiers

PMID41760346
PMCPMC12958905

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.