Hypertension epidemiology and primary care indicators in Portugal: a contemporary nationwide analysis

The Norte region showed consistently higher performance across monitoring and control indicators, whereas Algarve and Alentejo exhibited generally poorer results. BP monitoring and control improved across all regions, with the proportion of hypertensive adults aged 18-64 years, with BP <140/90 mmHg increasing from 29.3% in 2021 to 65.0% in 2025. Composite management indicators improved, but the degree of improvement varied between different index versions.

Medication costs generally increased up to 2024 but decreased afterwards, while prescription indicators remained stable, despite heterogeneous regional patterns.</p> <p>Hypertension management indicators in Portuguese primary care improved substantially between 2021 and 2025; however, regional disparities and methodological limitations remain. Current monitoring frameworks provide valuable real-world insights but incompletely capture clinically meaningful outcomes, supporting the need for more outcome-directed systems.</p> <p>What is the context: Hypertension is a major cardiovascular risk factor, and monitoring its management across Portugal's primary care system helps assess annual trends and regional difference.</p> <p>What is new: Between 2021–2025, hypertension prevalence rose slightly nationwide, particularly in Alentejo, although blood pressure control improved substantially across all regions, with Norte showing the strongest gains.</p> <p>What is the impact: Improved primary care hypertension indicators may reflect progress in disease management, changes in coding or recording practices, or both.

Future efforts should prioritize standardized blood pressure documentation and linkage of primary care, hospital, and cardiovascular outcomes data, enabling outcome-oriented surveillance that can guide health policies into addressing regional inequalities, and contributing to measurable improvements in morbidity and mortality.</p>