A district NCD officer reviews the hypertension cascade in her district and finds that only about half of hypertensive individuals are aware of their diagnosis, about half of those diagnosed are on treatment, and about half of those treated have their blood pressure controlled. This classical observation describing gaps at each step of hypertension care is known as:
- A The rule of thirds
- B The rule of halves ✓
- C The iceberg phenomenon
- D The treatment gap paradox
Correct answer: B. The rule of halves
Explanation
The rule of halves is the classical epidemiological observation in hypertension: roughly half of hypertensives are undetected, half of those detected are untreated, and half of those treated remain uncontrolled, so only about one-eighth achieve adequate control. It is used to justify population-wide opportunistic screening and simple protocol-based treatment. The iceberg phenomenon refers to hidden disease burden in the community generally, but the sequential halving at awareness, treatment and control steps is specifically termed the rule of halves.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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