Background Hypertension is a leading modifiable cause of cardiovascular mortality globally. Nationally representative data on the full hypertension care cascade prevalence, awareness, treatment, and blood pressure control are lacking for Bangladesh. This study estimated the burden of hypertension and identified determinants of each cascade stage to inform equity-sensitive policy.Methods We analysed data from 13,760 adults aged ≥ 18 years in the biomarker subsample of the Bangladesh Demographic and Health Survey 2022 (BDHS 2022), a nationally representative cross-sectional survey. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or current antihypertensive medication use. The care cascade was constructed sequentially across four stages: prevalence, awareness, treatment, and blood pressure control among treated adults. All analyses incorporated complex survey design features. Survey-weighted multivariable logistic regression identified independent determinants of each cascade stage, adjusting for age, sex, education, body mass index, diabetes, wealth quintile, and place of residence.Results Hypertension prevalence was 20.9% (95% CI: 19.9–21.9%). Among hypertensive adults, 56.7% (95% CI: 54.6–58.8) were aware of their diagnosis, 47.2% (95% CI: 45.1–49.3) were on treatment, and 44.2% (95% CI: 41.3–47.2) of those treated achieved blood pressure control. Advanced age was the strongest predictor of hypertension (adjusted odds ratio [AOR] for age ≥ 65 vs. 18–34 years: 15.77; 95% CI: 12.91–19.26). Female sex, overweight (AOR: 2.06), obesity (AOR: 3.52), diabetes (AOR: 1.50), and higher wealth were each independently associated with hypertension. Awareness and treatment were more likely among women, older adults, diabetic individuals, and wealthier quintiles. Higher educational attainment was the sole independent predictor of blood pressure control (AOR: 2.09; 95% CI: 1.28–3.42; control rates: 35.8% vs. 59.4% for no education vs. higher education). Sensitivity analyses confirmed robustness of findings.Conclusions One in five Bangladeshi adults has hypertension, yet fewer than half of those treated achieve blood pressure control. Critical care gaps concentrated among younger adults, men, the less educated, and economically disadvantaged populations reflect deep inequities in hypertension management. Universal screening, subsidised antihypertensive therapy, and strengthened primary care are urgently needed to reduce preventable cardiovascular mortality in Bangladesh.