[HEARTS in Guatemala: Implementation experience in addressing cardiorenometabolic risk, 2022-2025HEARTS na Guatemala: experiência de implementação para abordar o risco cardiovascular, renal e metabólico, 2022-2025].

Guatemala faces a growing burden of chronic noncommunicable diseases, with hypertension and type 2 diabetes mellitus being the leading contributors to cardiovascular mortality and progression to chronic kidney disease. In 2022, the Ministry of Public Health and Social Assistance began implementing the Pan American Health Organization/World Health Organization's HEARTS technical package to strengthen the prevention and clinical management of these conditions in low- and medium-complexity health care facilities. Between 2022 and 2025, the strategy was implemented in 11 Departmental Directorates of Integrated Health Services Networks and reached 104 municipal districts with an estimated resident population of 3 260 691 people aged 30 and older, equivalent to 43.9% of the national population in that age group. Clinical pathways, tools for patient follow-up and medication estimation were developed, and 624 health workers were trained through a train-the-trainer program. Between 2022 and 2025, morbidity records for hypertension, type 2 diabetes mellitus, and both conditions combined in low- and medium-complexity healthcare facilities rose from 232 932 to 318 099 people, reflecting an increase in the care burden recorded in the public health system. The Guatemalan experience documents the first steps toward a more organized and standardized primary care response to chronic noncommunicable diseases, with an emphasis on timely diagnosis, clinical follow-up, and management of hypertension and type 2 diabetes mellitus, to help prevent complications and reduce avoidable premature mortality.