Key result
Tanzanian adults face massive hypertension care gaps, leaving ~74% undiagnosed and most treated patients uncontrolled.
Why the study?
Hypertension awareness, treatment, and control remain very low across SSA despite high prevalence, necessitating an examination of the care cascade across diagnosis, treatment, and control stages in Tanzania to identify priority intervention areas.
Cross-Sectional (n=4,320)
Yes
This national survey reveals severe gaps across the hypertension care cascade in Tanzania—with 73.6% undiagnosed, 78% of diagnosed untreated, and 67% of treated uncontrolled—highlighting an urgent need for community-based screening and health system strengthening, particularly for younger and employed adults.
Answers are grounded in this paper and cite their sources.
Supports prioritizing hypertension awareness and treatment in Tanzania; leaves open effective strategies to improve control rates.
Background: Despite high prevalence, hypertension awareness, treatment, and control remain very low across SSA. This article aimed to examine the hypertension care cascade across diagnosis, treatment, and control stages to identify priority intervention areas Methods: This article analyses data from the Tanzania STEPS survey conducted from September to November 2023. The quantitative, cross-sectional, household-based survey used structured interviews, physical measurements, and biochemical samples to comprehensively assess NCD risk factors among adults aged 18–69 years. The survey was conducted in all 26 regions of mainland Tanzania and all 5 regions of Zanzibar. A total of 15 households per EA were sampled, yielding 4,320 individuals (one adult per household), drawn from 288 EAs Results: Most participants were female (60.4%) and most were aged 46–69 years (52.6%). A large proportion resided in rural areas (64.5%). Among individuals with raised blood pressure (SBP ≥140 and/or DBP ≥90 mmHg or on treatment), the majority were not previously diagnosed (73.6%), particularly among those aged 31–45 years (83.7%). Poor enrolment in antihypertensive treatment is high among known hypertensive individuals, affecting approximately 78% of those previously diagnosed. Younger individuals aged 18–30 years (92.6%) and 31–45 years (88.2%) exhibit markedly higher levels of poor enrolment compared to those aged 46–69 years (69.1%). Occupation is also significantly associated with treatment uptake (p = 0.021), with employed (84.4%) and self-employed individuals (81.6%) showing higher poor enrolment compared to others (69.7%). In contrast, sex, residence, marital status, education level, BMI, depression status, alcohol use, smoking, and physical activity are not significantly associated with treatment uptake. Among individuals receiving treatment (n=86), poor blood pressure control remains high at about 67%. Age group is again the only factor significantly associated with blood pressure control among those on hypertensive treatment. Older adults aged 46–69 years have the highest proportion of uncontrolled blood pressure (73.9%), compared to 50.0% among those aged 18–30 years Conclusion: The study shows large deficits in hypertension awareness, treatment initiation, and control across age and sex groups. Addressing these gaps requires population-level interventions to expand community-based screening, improve linkage to care, and strengthen health systems to support adherence and long-term management, with particular emphasis on early detection in men and younger adults and improved treatment and follow-up for all groups.
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Hassan et al. (2026) conducted a cross-sectional in Hypertension (n=4,320). Hypertension care cascade assessment (NCD risk factors and sociodemographic determinants) was evaluated on Hypertension care cascade stages: undiagnosed hypertension, poor treatment enrolment among diagnosed, and poor blood pressure control among treated. Among Tanzanian adults with hypertension, 73.6% were undiagnosed, 78% of diagnosed individuals had poor treatment enrolment, and 67% of treated individuals had uncontrolled blood pressure.
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