Evidence map›Paper›PMID 41574119›Full record

ArticleInternational journal of public health2025

Mapping the Dynamic Complexity of Hypertension Management in São Paulo, Brazil.

Pei Shan Loo, Anna Socha, Mariana Silveira, Yara Carnevalli Baxter, Álvaro Avezum, Luciano F Drager, Luiz A Bortolotto, Johannes Boch, Daniel Cobos Munoz

Abstract read
In one paragraph

Article in International journal of public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Pei Shan LooSwiss Tropical and Public Health Institute, Allschwil, Switzerland.
Anna SochaSwiss Tropical and Public Health Institute, Allschwil, Switzerland.
Mariana SilveiraBeneficência Portuguesa de São Paulo, São Paulo, Brazil.
Yara Carnevalli BaxterNovartis Foundation, São Paulo, Brazil.
Álvaro AvezumSociedade de Cardiologia do Estado de São Paulo, São Paulo, Brazil.
Luciano F DragerSociedade de Cardiologia do Estado de São Paulo, São Paulo, Brazil.
Luiz A BortolottoSociedade de Cardiologia do Estado de São Paulo, São Paulo, Brazil.
Johannes BochNovartis Foundation, Basel, Switzerland.
Daniel Cobos MunozSwiss Tropical and Public Health Institute, Allschwil, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Hypertension is a major cardiovascular risk factor in Brazil and globally, requiring effective healthcare system strategies. This study examines how the health system in São Paulo manages hypertension, identifying patterns and connections that influence patient outcomes and resource use. Methods: Using literature reviews and participatory discussions with experts, we developed a systems map, causal loop diagram, to illustrate dynamic complexity underpinning hypertension management. Thematic analysis of qualitative data informed the model, highlighting key interactions that shape screening, treatment, and long-term care. Results: The analysis reveals critical dynamics at individual, community, and system levels. Early diagnosis and expanded treatment access improve adherence and reduce complications. However, these improvements also increase the number of patients needing long-term care. This creates a challenge where healthcare gains today can raise future demands if prevention efforts are underfunded. Conclusion: Understanding these interconnections is crucial for balancing treatment expansion with sustainable prevention strategies. By mapping system-wide challenges, this study offers a framework to help policymakers allocate resources more effectively and strengthen urban health systems. Future research will focus on using simulation modeling to test policy interventions and improve hypertension outcomes.

Indexed as

Delivery of Health CareHypertensionBrazilHumansBrazilcausal loop diagramhypertensionSão Paulosystem thinking

Identifiers

PMID41574119
PMCPMC12819338

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.