{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T03:20:14Z","timestamp":1794108014554,"version":"4.8.0"},"reference-count":59,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009131","name":"Swiss Agency for Development and Cooperation","doi-asserted-by":"crossref","award":["7F-10345.01.01"],"award-info":[{"award-number":["7F-10345.01.01"]}],"id":[{"id":"10.13039\/100009131","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["323530_207035"],"award-info":[{"award-number":["323530_207035"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["P500PM_221961"],"award-info":[{"award-number":["P500PM_221961"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100018939","name":"World Diabetes Foundation","doi-asserted-by":"publisher","award":["WDF658 1778"],"award-info":[{"award-number":["WDF658 1778"]}],"id":[{"id":"10.13039\/501100018939","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypertension 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a population-based cross-sectional study nested within the Community-Based Chronic Care Lesotho (ComBaCaL) cohort study (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05596773\">NCT05596773<\/jats:ext-link>\n                      ). Adult cohort participants \u226518 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 \u2265140\/90\u2009mm Hg, and below-target hypertension as on-treatment systolic BP &lt;110\u2009mm Hg. Multivariate regression models were conducted to identify associated factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 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 \u226565 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 \u22653 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2025-020344","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:30:17Z","timestamp":1772202617000},"page":"e020344","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Untreated, uncontrolled and below-target hypertension in southern Africa: a population-based prevalence and care cascade assessment in rural Lesotho"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct05596773","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05596773","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5746-713X","authenticated-orcid":false,"given":"Iliana M","family":"Esquivel-Vald\u00e9s","sequence":"first","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland"},{"name":"University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Sanchez-Samaniego","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland"},{"name":"University of Basel, 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