Overview

• New guidance labels blood pressure of 120–139 mmHg systolic or 80–89 mmHg diastolic as pre‑hypertension, with normal now below 120/80 mmHg.
• All patients with hypertension should be treated to a target below 130/80 mmHg, with intensity individualized to tolerance and overall risk.
• Medication is indicated for readings at or above 140/90 mmHg, or for 130–139/80–89 mmHg after three months of lifestyle measures in high‑risk patients.
• The guideline adds SUS‑focused protocols and dedicated women's health recommendations, prioritizing public‑system drugs and wider use of MAPA and MRPA monitoring.
• Brazil aligns with recent European and U.S. shifts and cites evidence, including a Lancet analysis, showing intensive control reduces cardiovascular events but increases renal and hypotension‑related adverse effects requiring monitoring.