Overview

• The 2025 guideline from Brazil’s cardiology, nephrology and hypertension societies was released on September 18 at the 80th Brazilian Cardiology Congress.
• Readings of 120/80–139/89 mmHg are now classified as pre‑hypertension, while values at or above 140/90 mmHg define hypertension.
• All diagnosed patients should aim for blood pressure below 130/80 mmHg, with lower levels pursued if tolerated and careful monitoring for adverse effects.
• For those in the 12/8 range, non‑drug measures are first‑line; medication can start after three months for 130–139/80–89 mmHg if overall cardiovascular risk is high, and is indicated immediately at 140/90 or higher, preferably with a low‑dose dual combination in a single pill.
• The document incorporates the PREVENT 10‑year risk estimator, provides SUS‑focused protocols and guidance for women, and cites evidence of modest event reduction with intensive targets alongside higher risks such as renal events and hypotension.