The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study
6 affiliations
- 1Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- 2Health Sciences Research Office (HSRO), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- 3Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- 4MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- 5Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, Connecticut, United States of America
- 6Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
Abstract
Background: Hypertension (HTN) constitutes a major and growing public health challenge in South Africa, a setting where HIV prevalence also remains high. Despite this dual burden, longitudinal evidence describing how individuals move through the HTN care cascade particularly comparing people living with HIV (PLHIV) and people not living with HIV (PNLHIV) remains limited. Understanding patterns of progression and regression across the cascade is essential to inform health system strategies for integrated chronic disease management. Methods and findings: We conducted a longitudinal secondary analysis using data collected from the iHEART-SA trial, implemented across nine public primary healthcare clinics in Johannesburg between August 2022 and May 2024, with follow-up through May 2025. Adults (≥18 years) receiving chronic care, with a known HIV status and a completed medical file review were included. Progression and regression were assessed across the HTN care cascade. Conclusions: PLHIV had lower HTN diagnosis and higher regression, including treatment discontinuation and loss of BP control, underscoring persistent gaps in longitudinal HTN management within HIV programmes and the need for integrated and targeted chronic care models that ensure treatment continuity and sustained control. Why was this study done?: What did the researchers do and find?: What do these findings mean?:
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BibTeX
@article{gumede2026longitudinal,
title = {{The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study}},
author = {Siphamandla Bonga Gumede and Jennifer Manne-Goehler and Elizabeth Kelechi Oladimeji and Nicola Bulled and Alana T. Brennan and Samanta Tresha Lalla-Edward},
journal = {PLOS Medicine},
year = {2026},
month = sep,
doi = {10.1371/journal.pmed.1004957},
url = {https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004957},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study
AU - Siphamandla Bonga Gumede
AU - Jennifer Manne-Goehler
AU - Elizabeth Kelechi Oladimeji
AU - Nicola Bulled
AU - Alana T. Brennan
AU - Samanta Tresha Lalla-Edward
PY - 2026
DA - 2026/09/11
JO - PLOS Medicine
DO - 10.1371/journal.pmed.1004957
UR - https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004957
AB - Background: Hypertension (HTN) constitutes a major and growing public health challenge in South Africa, a setting where HIV prevalence also remains high. Despite this dual burden, longitudinal evidence describing how individuals move through the HTN care cascade particularly comparing people living with HIV (PLHIV) and people not living with HIV (PNLHIV) remains limited. Understanding patterns of progression and regression across the cascade is essential to inform health system strategies for integrated chronic disease management. Methods and findings: We conducted a longitudinal secondary analysis using data collected from the iHEART-SA trial, implemented across nine public primary healthcare clinics in Johannesburg between August 2022 and May 2024, with follow-up through May 2025. Adults (≥18 years) receiving chronic care, with a known HIV status and a completed medical file review were included. Progression and regression were assessed across the HTN care cascade. Conclusions: PLHIV had lower HTN diagnosis and higher regression, including treatment discontinuation and loss of BP control, underscoring persistent gaps in longitudinal HTN management within HIV programmes and the need for integrated and targeted chronic care models that ensure treatment continuity and sustained control. Why was this study done?: What did the researchers do and find?: What do these findings mean?:
SN - 1549-1676
ER -