Unveiling the Gaps: Hypertension Control Beyond the Cascade of Care Framework

This study examines hypertension control beyond the cascade of care framework, which assesses awareness, treatment, and control sequentially. The analysis included 52 434 hypertensive adults (blood pressure (BP) ≥140/90 mm Hg and/or treatment in the past 6 months), aged 25-69, from the French population-based CONSTANCES cohort from 2012 to 2021. The authors assessed the typical "awareness, treatment, and control" scenario and characterized other possible control patterns. The authors found that 13% achieved control. This percentage rose to 19% when considering individuals who were not aware but treated and controlled. This alternative control scenario was associated with female sex, younger age, higher education, Northern-African origin, and reporting prior cardiovascular diseases (CVD). Sub-Saharan African origin, diabetes and overweight/obesity were associated with the typical control scenario. This study highlights that applying a typical sequential cascade of care approach may lead to the exclusion of some specific groups of participants who do not fit into the defined categories.