This is a retrospective observational cohort study based on secondary use of routinely collected electronic health data. The design was selected to enable population-level characterisation of treatment patterns and clinical inertia (both diagnostic and therapeutic) in the management of hypertension across diverse settings in Brazil's public primary care system (SUS).
Age ≥18 years at the time of Hypertension diagnosis
Hypertension diagnosis as retrieved from registered ICD codes or CIAP Codes (primary care codes) in the EMR , OR At least two blood pressure measurements ≥140/90 mmHg during the study period. The blood measurements should be consecutive and obtained within a 30 days period.
Continuous follow-up in the same municipality for at least 6 months after index measurement.
Availability of structured EMR data including clinical encounters, diagnoses, and prescriptions
None
Adults registered in the e-SUS PEC system who had encounters with primary healthcare services within the study period and had blood pressure measurements recorded. We will assess data from the entire population of approximately 05 muncipalities (comprising between 100.000 and 250.000 inhabitants). The municipalities will be seleceted from a pre-screened list of 20 cities located within all Brazilian regions.
Cohort
Retrospective
Not listed
Uncontrolled blood pressure
Proportion of patients with uncontrolled blood pressure (BP ≥ 140/90 mmHg) who did not receive treatment intensification within 3 months of a recorded elevated BP.
Antihypertensive treatment
Proportions receiving monotherapy vs. combination therapy; distribution by pharmacologic class.
Risk stratification
Likelihood of treatment escalation stratified by low/moderate vs. high/very high CV risk.
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