Assessment of hypertension prevalence and care cascade performance toward the 80-80-80 targets in the HASP cohort study, India

Hypertension is a major contributor to cardiovascular morbidity and mortality in India, yet gaps remain across the care cascade, from diagnosis to treatment and control. Using baseline data from the ongoing Heart Attack and Stroke Predictability (HASP) cohort in Bengaluru, this study estimates hypertension prevalence, evaluates cascade performance, and examines sociodemographic, lifestyle, and psychosocial correlates among treated and untreated hypertensive adults. A cross-sectional analysis was conducted among 2028 adults aged 30–80 years recruited between April 2024 and January 2026. Hypertension was defined as self-reported antihypertensive medication use and/or systolic blood pressure ≥ 140 mmHg or diastolic ≥ 90 mmHg. Descriptive statistics assessed prevalence and cascade indicators. Group differences were examined using Chi-square and Mann–Whitney U tests. Logistic regression identified factors associated with (i) being on antihypertensive treatment and (ii) having undiagnosed elevated blood pressure. Hypertension prevalence was 37.1% (371/1000). Among hypertensive participants, 41.5% were aware of their condition; of those aware, 95.5% were on treatment, and 50.3% of the treated had controlled BP. Age was strongly associated with hypertension and treatment uptake. Lower education and male sex were associated with undiagnosed elevated BP. Short sleep duration (< 7 h) and low fruit consumption were significantly associated with undiagnosed hypertension, while socioeconomic differences attenuated among those receiving treatment. Although treatment adherence and control among diagnosed individuals were relatively high, low awareness remains a critical barrier to achieving the 80-80-80 hypertension target. Targeted screening of men, younger adults, and low-education groups, alongside interventions promoting healthy diet and adequate sleep, may strengthen early detection and control efforts in similar urban–rural Indian settings.