BRAZILIAN GUIDELINES FOR ARTERIAL HYPERTENSION 2025: NEW EVIDENCE FOR CLINICAL MANAGEMENT

Abstract

Systemic arterial hypertension is one of the most significant chronic public health diseases worldwide, representing a major risk factor for the development of cardiovascular, cerebrovascular, and renal diseases. This study aimed to analyze and discuss the main updates introduced in the 2025 Brazilian Hypertension Guidelines. This is a narrative literature review, with a descriptive and exploratory approach, developed from consultation of the PubMed, LILACS, SciELO, Brazilian Archives of Cardiology databases and official documents made available by the Brazilian Society of Cardiology. The results showed significant advances in the diagnosis of hypertension, highlighting the greater emphasis on ambulatory blood pressure monitoring and home blood pressure measurement, associated with the improvement and standardization of measurement procedures. Among the main changes, there is an expansion of cardiovascular risk stratification, including individuals with blood pressure ≥130/80 mmHg and the incorporation of the very high cardiovascular risk category. Therapeutic goals now prioritize blood pressure values ​​below 130/80 mmHg for most patients. The guideline highlights the relevance of non-pharmacological interventions, such as weight control, regular physical exercise, a healthy diet, and smoking cessation. In the pharmacological realm, the early introduction of combination therapies, preferably in single-tablet formulations, is recommended. It also emphasizes the importance of primary health care, longitudinal follow-up, and the incorporation of digital technologies, especially telemedicine, in the management of hypertension. Thus, the proposed updates favor a preventive, personalized, and integrated approach, contributing to improved blood pressure control and a reduction in cardiovascular morbidity and mortality in the Brazilian population.