ArticleHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2026
Treatment of Hypertensive Crisis in Primary Care Health Facilities in Peru, 2019-2024.
Article in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Digital pharmacoepidemiology of angiotensin-converting enzyme inhibitors in Russia.Frontiers in pharmacology · 2026Article
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Abstract
introductionHypertensive crises are often managed in primary care, yet guideline-discordant use of short-acting oral antihypertensives remains common in low- and middle-income countries.
aimWe aimed to describe prescribing patterns of captopril, nifedipine, furosemide, and metamizole in Peru.
methodsWe conducted a retrospective cohort study using nationwide data from the Peruvian Seguro Integral de Salud (2019-2024). Adults with hypertension and at least one hypertensive crisis episode (systolic blood pressure [BP] ≥ 180 mmHg and/or diastolic BP ≥ 110 mmHg) in primary care were included. Joinpoint regression assessed temporal trends, and multivariable logistic regression identified prescribing determinants.
resultsWe analyzed 163,166 episodes from 101,894 patients (mean age 67.3 ± 13.7 years, 60.9% women). Captopril use declined from 40.3 to 34.5% (average monthly percent change [AMPC] - 0.22%; p < 0.001), with steepest decreases in level I-1 healthcare facilities and patients ≥ 80 years. Nifedipine showed no significant overall change (AMPC + 0.07%; p = 0.406) but rose mid-period before declining. Combined captopril or nifedipine use decreased modestly (AMPC - 0.21%; p < 0.001). Furosemide or metamizole were prescribed in 4.7% of episodes, with stable trends but increases in level I-1 healthcare facilities. Higher systolic BP increased the probability of prescribing all medications; diastolic BP showed a non-linear association peaking at 100-110 mmHg. Younger ages were associated with greater medication use.
conclusionsShort-acting antihypertensives and other agents remain common in Peruvian primary care hypertensive crises. Targeted strategies are needed to align practice with evidence-based recommendations.
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