78
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
PARTICIPATORY DIAGNOSIS OF HYPERTENSIVE PATIENTS IN
THE FAMILY HEALTH STRATEGY: EXPERIENCE REPORT IN THE
TERRITORY OF EUNÁPOLIS, BRAZIL
Flaelma Almeida da Silva1
Flávia Rocha Brito2
Diana de Lima3
Ariel Vitoriano Leonel4
Cícera Jéssica Gomes Belém5
Francisco Galdino Neto6
Hemylly Ismyrlly de Lavor7
João Victor dos Santos de Deus8
Livia Pereira Santos9
Soa Maria Ferreira Moreira da Silva10
Abstract: This article presents an experience report derived from a university outreach project linked
to the Medical School of Faculdade Pitágoras de Eunápolis, aiming to strengthen primary health care
through the analysis of the prole of hypertensive patients enrolled in the Moisés Reis Basic Health Unit,
1 Master in Education, CETSC Professor at the Pitágoras Faculty of Medicine of Eunápolis.
2 Master in Nursing and Health, Professor of PINESC at the Pitágoras Faculty of Medicine of
Eunápolis
3 PhD in Environmental Engineering Sciences, CETSC Professor at the Pitágoras Faculty of
Medicine of Eunápolis.
4 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
5 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
6 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
7 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
8 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
9 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
10 Medical Student at Faculdade Pitágoras de Medicina de Eunápolis
79
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
located in the municipality of Eunápolis, Bahia, Brazil. The initiative involved territorial mapping of a
micro-area, home visits, educational dialogue, and the application of a semi-structured questionnaire
addressing lifestyle habits, clinical aspects, and treatment adherence. The methodology adopted was
quantitative-descriptive, without any interventional or invasive procedures, in full respect of ethical
principles and local health realities. The ndings revealed a predominance of women over 50 years
of age, high adherence to antihypertensive medication, regular engagement in leisure activities, and
low incidence of smoking and alcohol consumption. However, many participants presented altered
blood pressure levels and symptoms associated with hypertension. The experience highlighted the
positive impact of educational actions and active listening on users’ awareness of their own health
conditions. The project reinforces the transformative role of university outreach in medical education
by integrating scientic knowledge with social commitment and generating relevant data for public
health planning.
Keywords: Hypertension; university outreach; primary health care; epidemiological prole; lifestyle
habits.
INTRODUCTION
Systemic arterial hypertension (SAH) is one of the main public health problems in Brazil and
worldwide, characterized by its high prevalence, multiple causes, and strong association with severe
clinical outcomes, such as acute myocardial infarction, stroke, and chronic renal failure. According to
the Ministry of Health (2023), approximately 27.9% of the Brazilian adult population is hypertensive,
with a higher incidence among women and the elderly. In Bahia, this prevalence follows the national
average, being observed especially in communities with low income, limited access to health services,
and a high rate of sedentary lifestyle and poor diet (SESAB, 2023). These data highlight the need for
territorialized surveillance and intervention strategies, especially in the context of primary care.
The Family Health Strategy (FHS), a central component of Primary Care of the Unied
80
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
Health System (SUS), aims to promote comprehensive and continuous care for the enrolled population,
acting on the social determinants of health and prioritizing prevention and promotion actions. In the
context of arterial hypertension, the FHS plays a decisive role, as it enables the continuous monitoring
of cases, guidance on healthy habits and the strengthening of the bond between professionals and
users. However, despite the recommended structure, there are still signicant gaps in the precise
identication of local epidemiological proles and in the development of personalized care actions,
especially in peripheral and vulnerable communities.
Hypertension is a multifactorial chronic disease, whose etiology involves the interaction
between genetic, environmental, physiological, and behavioral factors (Porto, 2019; Brazilian Society
of Cardiology, 2020). Studies such as those by Sanjuliani (2002) and Brasileiro Filho (2021) point
out that advancing age, the presence of comorbidities such as diabetes mellitus, chronic stress, poor
diet, smoking, excessive alcohol consumption, and physical inactivity are determining factors for the
development and worsening of SAH. In this sense, the understanding of the prole of hypertensive
patients in a given territory must go beyond biomedical aspects and also consider the social and
cultural determinants that structure the health-disease process.
In the Moisés Reis neighborhood, located in the urban area of the municipality of Eunápolis-
BA, there is a population with markedly heterogeneous characteristics, whose living conditions directly
inuence the patterns of illness. The absence of updated and systematized data on hypertensive patients
in the region motivated the elaboration of this extension project, with the objective of carrying out a
participatory diagnosis with users registered in the local Basic Health Unit (UBS). The action was
based on home visits, territorialization of the micro-area and active listening to the subjects, respecting
their experiences and singularities, in order to subsidize professional practice with empirical data and
contribute to the development of more effective care strategies.
The central problematization that guided the experience lies in the disconnection between
the ofcial notication data and the reality experienced by hypertensive users in the community. In
many cases, there is low adherence to treatment, incorrect use of medication, lack of knowledge about
81
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
adverse effects, and lifestyle habits that are not compatible with adequate blood pressure control,
even in the face of free access to health services. Such a scenario suggests the existence of not
only structural, but also communicational and educational barriers, which compromise the clinical
management and autonomy of patients. In view of this, it is urgent to investigate how these subjects
experience the hypertensive condition and how their daily practices interfere in the effectiveness of
public health policies.
The theoretical basis that underlies this experience includes classic and contemporary authors
on hypertension, public policies, health promotion and care practices. Sanjuliani (2002), Porto (2019)
and Antczak (2005) contribute to the clinical, pathophysiological and classicatory denition of SAH,
while Loyola and Jardim (2018) and Leinig (2023) discuss the relationship between diet, obesity and
blood pressure. In the psychosocial dimension, studies such as those by Aparecido (2014) and Paredes
and Ribeiro (2014) highlight the inuence of stress, job insecurity, and socioeconomic inequalities on
the worsening of the disease. These authors are fundamental to understand the complexity of health
care in the daily routine of basic units.
In addition, scientic production on quality of life and adherence to treatment has pointed out
that coping with SAH requires interdisciplinary approaches and subject-centered strategies. Authors
such as Hanus et al. (2015) and Cha et al. (2012) indicate that sleep disorders, cognitive dysfunctions,
mood disorders, and difculties in sexual life are often associated with uncontrolled blood pressure.
Such manifestations, often neglected in clinical consultations, emerge strongly in participatory
approaches such as the one carried out in this project. The use of semi-structured questionnaires
allowed these dimensions to be captured in a sensitive way, bringing the scientic view closer to the
reality experienced by the patients.
Another central point in the study’s rationale is the territorialized approach to health,
defended by Bissacotti et al. (2019), who consider territorialization an indispensable instrument
for the planning of public health actions. The construction of bonds during home visits and the
recognition of the territory as a living space of care enabled the development of qualied listening and
82
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
the collection of consistent data. This allowed not only to describe the sociodemographic and clinical
prole of hypertensive patients, but also to identify gaps in health education, daily habits, and users’
understanding of their own diagnosis.
Thus, this article aims to report the experience of participatory diagnosis of the prole of
hypertensive patients followed by the Family Health Strategy at the UBS Moisés Reis, highlighting
the relevant ndings on lifestyle habits, associated symptoms, use of medications and perception of
one’s own health condition. It seeks, with this, to contribute to the strengthening of comprehensive
care practices in primary care, in addition to reinforcing the importance of university extension as a
formative space and transformer of social reality.
Finally, it is understood that the construction of this knowledge, based on systematic
observation and the active participation of the subjects, expands the role of the public university in the
production of contextualized solutions to the challenges faced by the SUS. The articulation between
theory and practice, between science and community, between teaching and care, reveals itself as a
possible and necessary path for the consolidation of a more humanized, critical medicine committed
to the social determinants of health.
METHODOLOGY
This is an experience report study, with a quantitative-descriptive approach, based on the
activities developed by students of the Medicine course at Faculdade Pitágoras de Eunápolis, within
the scope of a university extension project linked to the CETSC and PINESC axes. The main purpose
of the action was the critical and humanized training of future health professionals, based on direct
contact with the local reality and the participatory analysis of the prole of hypertensive individuals
enrolled in the Family Health Strategy (ESF) at the Moisés Reis Basic Health Unit, located in the
municipality of Eunápolis, in the extreme south of Bahia.
The experience took place during the second half of 2024, with the micro-area corresponding
83
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
to Avenida Domingos Reis, a territory attached to the UBS Moisés Reis, where home visits,
educational activities and the application of collection instruments were carried out. The location was
chosen due to the signicant presence of hypertensive patients, previously mapped in partnership
with community health agents and professionals from the unit itself, based on the registration of the
Primary Care Information System (SIAB).
The sample consisted of 13 hypertensive individuals, out of the 19 initially identied and
invited to participate, resulting in an adherence rate of 68.42%. All participants were registered at the
UBS and voluntarily agreed to contribute to the project. It should be noted that, as this is a report of
academic experience in extension, there was no invasive collection of sensitive data or therapeutic
intervention, only observation and educational record, which is in line with the formative practices
guided by the National Curriculum Guidelines of the Medicine course, which encourage teaching-
service-community integration.
The instrument used for data collection was a semi-structured questionnaire, with open and
closed questions, adapted from the model validated by Gusmão and Pierin (2009), originally aimed
at assessing the quality of life in hypertensive patients. The version used was reformulated by the
students and professors to meet the objectives of the project, maintaining 35 questions pertinent to the
clinical, physiological, socioeconomic and behavioral dimensions of the participants. The application
of the instrument was carried out in person, in a home environment, with respectful reception and
active listening, prioritizing accessible language and the bond between the academic team and the
community.
In addition to the questionnaire, observational records were made during the visits, including
voluntary blood pressure measurement in nine of the thirteen participants, using a calibrated
sphygmomanometer and stethoscope. The measurement followed the clinical protocols recommended
by the Brazilian Society of Cardiology (2020), and had a formative character, being conducted under
faculty supervision. The experience was enriched by an educational dynamic with the use of colored
stickers (red, blue and yellow), developed as a strategy to help elderly and illiterate patients in the
84
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
organization of medication and times of use, promoting greater therapeutic adherence.
Regarding the ethical aspects, although this is not a research with clinical or risk implications,
the principles of Resolution No. 510/2016 of the National Health Council were followed. All participants
were informed about the objectives of the project, about the educational nature of the activity and
about the non-obligation to answer the questions or allow blood pressure to be measured. A Free and
Informed Consent Form (ICF) was obtained in a physical form, signed by the participants themselves
or their legal guardians. The data collected were kept condential, stored in a safe place, under the
responsibility of the teaching team, and will be used exclusively for academic and scientic purposes,
respecting the anonymity and condentiality of the information.
The methodological proposal, centered on extension practice and participant observation,
sought to integrate theoretical knowledge about arterial hypertension with the reality experienced
by primary care users, allowing students to critically understand the social determinants of health,
barriers to care and the importance of qualied listening. It is, therefore, a training process that values
the ethical, political and human dimension of medical education, while contributing to local health
planning.
DISCUSSION AND ANALYSIS OF RESULTS
The demographic composition of the sample group revealed a predominance of females
(69.23%), with all women over 50 years of age. This nding conrms the trend described by Brasileiro
Filho (2021), according to which the prevalence of hypertension is more pronounced among adult
women, especially after menopause, when there is a sharp drop in estrogen levels and consequent loss
of vascular protection. The literature also points out that vascular aging, characterized by reduced
arterial compliance and increased peripheral resistance, is a determining factor for blood pressure
elevation, especially in postmenopausal women (Porto, 2019; Sanjuliani, 2002).
The average age of the participating men was even higher (72.75 years), which corroborates
85
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
data from the Brazilian Society of Cardiology (2020) on hypertension as a condition that accompanies
advancing age. In this context, the ndings of the present study indicate that the hypertensive
population cared for by the Moisés Reis UBS has an age prole that requires increased attention,
considering the risk of comorbidities and clinical complications common in the elderly. This nding
reinforces the importance of longitudinal care and constant blood pressure surveillance as a strategy
for disease prevention.
The occupational situation of the participants showed a contingent mostly made up of
retirees (38.46%), followed by people with unpaid employment (23.07%) and individuals on sick leave
(15.38%). Such socioeconomic conguration indicates nancial fragility and high dependence on the
public health system. According to Aparecido (2014), arterial hypertension is closely associated with
the socioeconomic position of the subjects, being more prevalent in low-income populations, with
limited access to resources that favor healthy lifestyle habits. These data were visibly represented in
Graph 1 – Occupational situation of the sample group, to be inserted in this section.
Graph 1 – Occupational situation of the sample group
Source: Field research, 2024.
86
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
Although the social determinants of health are widely recognized as conditioning factors
of hypertension, it is observed that the impact of these conditions on adherence to treatment and
quality of life is still underestimated in primary care services. Paredes and Ribeiro (2014) highlight
that chronic stress associated with economic instability, precarious retirements, and informal jobs
contributes to the increase in blood pressure levels, generating cycles of progressive illness. The
absence of integrated actions between the health sector and social assistance therefore compromises
the effectiveness of care.
The age and occupational distribution of the group studied suggests that hypertension
manifests itself in a context of multiple vulnerabilities, which reinforces the need for intersectoral
approaches. The articulation of the FHS with the equipment of the social assistance network, such as
the CRAS and the living services for the elderly, can expand the capacity to cope with risk factors
and favor the construction of unique therapeutic projects. The experience lived by the academic
team during the extension project allowed the direct observation of this complexity and signaled
the importance of territorialization as a care management tool, as recommended by Bissacotti et al.
(2019).
The survey of the participants’ lifestyle habits revealed signicant data regarding the
prevention and control of arterial hypertension. Of the thirteen individuals interviewed, 84.62%
stated that they did not use alcoholic beverages or tobacco. This information is consistent with clinical
guidelines that point to alcoholism and smoking as aggravating factors for hypertensive conditions.
According to Souza (2015), cigarette use directly interferes with blood pressure levels, increasing
heart rate and vascular resistance, while alcohol, even in moderate doses, can reduce the effectiveness
of antihypertensive medications, as described by Klatsky (2015).
The low incidence of smoking and alcohol consumption in the sample can be interpreted
as a protective factor, but it is necessary to consider the possibility of underreporting due to social
embarrassment at the time of the household interview. Even so, the predominance of abstaining habits
87
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
may be related to the age prole of the group and the advancement of the health education process in
the communities linked to the Family Health Strategy. In studies conducted by Morillo et al. (2006), it
was observed that smokers had signicantly higher mean blood pressure values than nonsmokers, even
under continuous medication. This reinforces the importance of maintaining professional alertness
even among users who report not smoking, especially when there are clinical signs of uncontrolled
blood pressure.
Regarding the practice of physical activity, 46.15% of the participants stated that they
performed some type of regular exercise, with walking being the most frequent activity, followed by
cycling. The relevance of this practice for blood pressure control is widely recognized in the literature.
Studies by Nogueira et al. (2012) and Lin and Lee (2018) show that aerobic exercise, practiced regularly,
contributes to the reduction of systolic and diastolic blood pressure, in addition to improving the
functional capacity and cardiovascular tness of hypertensive patients. In the present study, although
adherence to physical activity is still lower than desired, the presence of active individuals indicates a
potential to be strengthened by the FHS teams through educational actions and community walking
groups.
Leisure practices, in turn, were reported by 92.3% of the participants, who highlighted
activities such as going to church, walking, watching television, meeting friends and doing manual
work, such as knitting and sewing. The literature recognizes leisure as an essential element for mental
health and general well-being, especially in contexts of chronic diseases. According to Baldissera and
Bueno (2012), leisure contributes signicantly to the reduction of anxiety and stress, factors closely
linked to uncontrolled blood pressure. In addition, Mori and Silva (2010) observe that the presence of
family ties and the maintenance of affective bonds are associated with a better physiological response
to the treatment of SAH, which was also identied in the present sample.
88
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
Graph 2 – Leisure practices declared by the sample group
Source: Field research, 2024.
These data demonstrate that, although the group presents important protective behaviors,
such as abstention from tobacco and alcohol and the presence of leisure practices and, in part, physical
exercise, there are still gaps regarding the regularity and intensity of these actions. As pointed out by
Santos et al. (2005), the effectiveness of non-pharmacological measures depends on their constancy
and adequate guidance on the part of health professionals. Thus, the extension experience allowed
not only to identify the habits reported by the participants, but also to reect on the importance of
reinforcing systematic educational practices adapted to the sociocultural conditions of each territory.
Regarding pharmacological treatment, it was observed that 100% of the interviewees
used antihypertensive drugs, which reects partial access to the clinical protocol for hypertension
management within the scope of the SUS. This universality, however, should not be interpreted as
synonymous with full therapeutic adherence, since 15.38% of the participants reported difculty
89
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
in correctly organizing medication schedules, a fact that directly impacts the effectiveness of the
treatment. According to Sousa and Santiago (2018), medication adherence involves not only the
possession of medications, but the understanding of their importance, regular use, and management
of side effects, aspects that still present weaknesses in the context of primary care.
The presence of difculties in adherence was especially noted among illiterate and elderly
participants with a history of frequent forgetfulness. The phenomenon of polypharmacy, frequent in
this population, aggravates this scenario. As pointed out by Nascimento et al. (2019), the use of many
medications increases the chance of drug interactions and the risk of adverse effects, in addition to
compromising memory and understanding of the therapeutic scheme. In the sample studied, at least
three participants reported confusing the time and name of the medications, and it was common to
report ingestion outside the schedule or even on an empty stomach, contrary to the clinical prescription.
To mitigate these difculties, an educational strategy was used based on the use of colored
stickers: blue for morning, yellow for afternoon and red for night, pasted directly on the drug packages.
This simple and low-cost intervention proved to be effective as a resource to facilitate the therapeutic
routine, especially for subjects with low education. According to Silva et al. (2022), visual and tactile
resources are effective in promoting therapeutic adherence among patients with cognitive difculties,
especially when inserted in a context of humanized and individualized care. The use of colors, in this
case, allowed an intuitive association and was well accepted by the participants.
Source: Prepared by the authors, 2024.
90
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
During the dialogues with the interviewees, it was also observed that many of them received
help from family members, neighbors or community agents to control their blood pressure and provide
guidance on the use of medications. This informal support network is essential for the home care of
people with chronic diseases. For Ciosak et al. (2013), hypertension, as a condition of continuous
management, requires collaborative strategies that involve not only the patient, but also their social
environment, favoring co-responsibility and shared surveillance. The extension observation of this
community bond allowed students to understand the importance of support networks in therapeutic
success, especially in territories marked by vulnerability.
Despite individual and community efforts, two of the interviewees (15.38%) reported recent
episodes of hypertensive crises, with symptoms such as severe headache, blurred vision, and a feeling
of pressure in the chest. These reports show that the simple prescription of medications is not enough
to guarantee the clinical control of hypertension. According to Cha et al. (2012), the subjective
perception of symptoms and the way the patient deals with them have a strong inuence on adherence
and treatment effectiveness. This reinforces the need for continuous monitoring, frequent educational
interventions and, above all, qualied listening during primary care care.
During the home visits, it was possible to identify that 53.85% of the interviewees reported
symptoms compatible with uncontrolled blood pressure, the most frequent being: persistent headaches,
blurred vision, dizziness, sensation of pressure in the neck and palpitations. These ndings, although
subjective, are consistent with those described in the medical literature on clinical signs of poorly
controlled hypertension. According to Rodrigues et al. (2021), even medicated patients may present
symptoms as a result of hypertensive peaks caused by stress, inadequate diet, or failures in therapeutic
adherence. This reinforces the need for continuous and personalized follow-up, with an emphasis on
listening and evaluating warning signs.
Blood pressure was measured during the consultations with the consent of the participants
and revealed that approximately 38.5% had levels above the reference values (≥140/90 mmHg), even
91
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
with regular use of medications. This data reinforces the idea that the control of SAH goes beyond the
use of medication, requiring behavioral changes and constant vigilance. According to the Brazilian
Society of Hypertension (2020), about 50% of hypertensive patients in Brazil have inadequate blood
pressure control, which is due to both low adherence and insufcient comprehensive care offered in
basic health units.
Another relevant piece of data refers to the participants’ perception of listening to health
professionals. About 46.15% stated that they “always feel heard” in consultations, while 38.5%
answered that they are “sometimes” listened to and 15.3% reported that they “rarely or never” feel
heard. These results demonstrate advances in the bond between user and team, but still indicate gaps
in health communication. As Ayres (2004) points out, qualied listening is one of the pillars for
expanded health care, being indispensable for the construction of a therapeutic project that respects
the uniqueness of each subject and their life history.
The perception of partial or non-existent listening has direct implications for treatment
adherence and the user’s sense of belonging to the service. According to Schraiber and Mendes-
Gonçalves (2018), when health professionals assume a verticalized and technicist posture, the care
relationship is weakened, generating distance and distrust on the part of the user. In the present study,
the reports of intermittent listening indicate that, although there is effort on the part of the teams,
investments are still needed in continuous training processes that emphasize welcoming, bonding and
empathetic communication as central elements of care.
92
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
Graph 3 – Users’ perception of professional listening in the UBS
Source: Field Research, 2024.
In this sense, the extension project allowed medical students to experience, in practice, the
complexity of the relationships established between users and professionals of the Family Health
Strategy. Direct observation, combined with dialogue with the participants, revealed that listening
is not restricted to verbalization, but involves attitudes, body language, available time and ethical
posture in the face of the suffering of others. As Franco (2013) points out, listening is a clinical
and political device, which requires from the professional not only technical availability, but also
human sensitivity. The experience contributed, therefore, to the training of physicians who were more
attentive to the subjective dimensions of care.
The strengthening of the bond between users and the Family Health Strategy (FHS) teams
emerged as one of the central elements observed during the participatory diagnosis. Most of the
93
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
interviewees reported knowing the professionals who work in their area by name, which reveals a
certain degree of affective closeness and trust. This type of bond is fundamental for the success of
prevention and health promotion actions, as highlighted by Stareld (2002), who points to continuity
of care as one of the essential attributes of primary care. In the context of hypertension, where the
maintenance of treatment depends on continuous follow-up, this link between professional and patient
represents a determining factor.
Despite the positive reference to professionals, some participants reported excessive turnover
of doctors and nurses in the unit, which makes it difcult to consolidate lasting bonds. This reality is
common in municipalities in the interior, where temporary hiring and low retention of professionals
compromise the longitudinality of care. According to Mendes (2011), the discontinuity of the technical
team disrupts the territorialized planning of primary care, weakens the singular therapeutic project
and disfavors the control of chronic conditions such as arterial hypertension. In the present report,
this frailty was reported by elderly people who, over time, were monitored by different professionals,
which affected the quality of listening and safety in treatment.
Territorialization, a structuring principle of the FHS, was also evidenced in the experience.
The health professionals were well aware of the environmental, socioeconomic and family conditions
of the residents served, which facilitated the construction of guidelines adjusted to the local reality.
According to Campos and Campos (2006), the recognition of the territory as a living and dynamic space
allows care to be constructed in a contextualized way, sensitive to the vulnerabilities and potentialities
of each community. The extension observation revealed that, even in the face of scarcity of material
resources, the teams sought creative ways to act, using community spaces and local support networks
to promote educational meetings and self-care actions.
From the pedagogical point of view, the experience in the territory represented a signicant
expansion of the medical training of those involved in the project. The approach to the users and
the listening to their stories allowed for a situated learning, which goes beyond the limits of the
classroom and challenges traditional medical rationality. As Ceccim and Feuerwerker (2004) argue,
94
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
extension activities enable formative experiences that promote the articulation between academic
and popular knowledge, contributing to the construction of ethical, political and communicational
skills indispensable to medical practice in the SUS. The students’ reports showed greater empathy,
understanding of social determinants and appreciation of teamwork after the experience.
Graph 4 – Representation of the bond and territorialization from the perception of users
Source: Field Research, 2024.
Finally, the experience demonstrated that the direct involvement of students in the health
actions of the territory not only enriches their technical training, but also stimulates the commitment
to humanized care and the transformation of local realities. As pointed out by Paulo Freire (1996),
“no one educates anyone, no one educates himself, men educate themselves, mediated by the world”.
In this sense, health education carried out in contact with the territory also becomes a process of re-
education of future professionals, to the extent that it brings academic knowledge closer to people’s
concrete lives, their needs, values and experiences.
95
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
The analysis of the social determinants of the participants’ health revealed a signicant
socioeconomic vulnerability. Approximately 76.9% of the interviewees lived with a monthly income
of less than two minimum wages, most of whom were retired or unemployed. This data has a direct
impact on the ability of individuals to maintain a care routine, including adequate nutrition, acquisition
of complementary medications not offered by the SUS, and regular physical activity. According to
Buss and Pellegrini Filho (2007), social determinants are congured as structuring elements of the
health-disease process, and should be considered as priority axes in the formulation of public policies
and in the planning of health actions.
Housing conditions were also pointed out as factors that negatively impact the health of
the interviewees. Several participants reported living in homes with a precarious structure, without
adequate ventilation or natural lighting, which contributes to a sedentary lifestyle, social isolation
and the worsening of comorbidities, such as diabetes and obesity. For Barata (2009), the physical
environment in which one lives exerts a direct inuence on the quality of life and the control of chronic
diseases, and it is essential that health surveillance incorporates such elements in its territorialized
action.
Another important aspect identied in the study was the relationship between schooling and
understanding of treatment. About 38.5% of the participants were illiterate or had only incomplete
elementary school, which had a direct impact on the understanding of medical prescriptions, the
organization of medication and adherence to healthy practices. According to Paim (2013), schooling
is an important indicator of access to health information, and its absence tends to compromise
the subject’s autonomy in self-care. This nding reinforces the need for personalized educational
strategies, with accessible language and visual methods, such as those used in the project.
The absence of regular public transportation in the peripheral regions and the difculty in
locomotion reported by the elderly were also identied as barriers to continuous follow-up in the UBS.
In some situations, the interviewees reported interrupting the treatment because they were unable to
attend the review appointments or pick up the medications at the unit. According to Almeida Filho
96
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
(2018), geographic access continues to be an important challenge for the consolidation of primary care
in Brazil, especially in municipalities with disorderly urban expansion. Such conditions reinforce the
importance of home visits and the work of community health agents as a strategy for approximation
and continuity of care.
Graph 5 – Socioeconomic conditions and barriers to care identied in the participants
Source: Field Research, 2024.
Finally, food insecurity was directly mentioned by four interviewees, who reported difculty
in maintaining an adequate diet to control blood pressure, especially with regard to the intake of fruits,
vegetables and foods with low sodium content. The restrictive diet recommended for hypertensive
patients, despite being widely disseminated, comes up against the economic and cultural limitations
of the public served. As Jaime and Figueiredo (2014) point out, the promotion of healthy eating must
be articulated with food and nutritional security policies, ensuring physical, nancial and symbolic
97
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
access to healthy foods. In the context of the research, it was evident that, in addition to technical
guidance, it is necessary to understand and act on the real conditions that limit food choices.
The extension experience lived by the students during the participatory diagnosis allowed
the articulation between theoretical knowledge and practice in real territory, reafrming the social
function of the university. Direct contact with SUS users, mostly elderly people and in vulnerable
situations, generated deep reections on the limits of medical practice and the importance of effective
and humanized communication practices. According to Ceccim and Feuerwerker (2004), medical
education should integrate ethical-political and sociocultural components, promoting the development
of competencies that go beyond the technical domain and promote active listening, welcoming and
co-responsibility.
The students reported, in their written feedback, that the experience contributed to the
resignication of their perception of systemic arterial hypertension. Instead of understanding the
condition only as a clinical diagnosis based on blood pressure parameters, they began to perceive
its complexity as a social, relational, and historical phenomenon. According to Campos (2000),
comprehensive care is only possible when the professional recognizes the subject in its entirety,
considering the multiple determinants that affect their health. In this sense, the exercise of critical
observation and dialogue with users were essential formative elements.
Another relevant impact was the recognition of the importance of nonviolent communication
and accessible language. Many students reported initial difculties in adapting the biomedical
vocabulary to the comprehension needs of users, especially those with low education. Over time, they
developed facilitating strategies, such as the use of drawings, diagrams and visual materials, including
in the organization of medications. This practice is aligned with the National Curriculum Guidelines
for Medical Courses, which emphasize the training of professionals capable of establishing effective,
sensitive and appropriate communication in different contexts (Brasil, 2014).
The extension practice also favored multiprofessional teamwork and the appreciation of
local knowledge. At various times during the activity, the students observed how the Community
98
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
Health Agents played a fundamental role in the mediation between the UBS team and the community,
offering information about routines, habits, access difculties and affective bonds. This recognition
of the interdependence between technical knowledge and popular knowledge is one of the foundations
of popular health education, as discussed by Vasconcelos (2008), and represents an advance in the
process of building subjects committed to the transformation of social realities.
Graph 6 – Students’ perception of the impact of the extension experience on medical education
Source: Field Research, 2024.
Finally, the students themselves highlighted the relevance of the activity for the consolidation
of their professional identity in training. The exercise of listening, the understanding of the social
determinants of health, the recognition of the SUS as a fundamental public policy and the experience
99
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
of the territory as a pedagogical space were mentioned as signicant milestones in the academic
trajectory. Such elements converge with the concept of critical-reective competence, proposed by
Almeida et al. (2021), which considers essential the ability to analyze contexts, dialogue with subjects,
and build unique solutions to complex problems in the eld of health.
The educational interventions carried out during the participatory diagnosis demonstrated
formative potential for both students and users. Through conversation circles, individual guidance and
adapted visual materials, it was possible to stimulate the participants’ protagonism in the management
of their own chronic condition. The use of accessible pedagogical strategies, such as the organization
of medications with colored stickers, facilitated the understanding of schedules and dosages, especially
among those with low education. According to Freire (1996), the educational process is only effective
when it starts from the concrete reality of the subjects, allowing them to recognize themselves as
agents of transformation of their own lives.
The Basic Health Unit (UBS), as the locus of extension action, played an essential role in
the articulation between clinical care and educational practices. The partnership between the UBS
team and the extension workers enabled an expanded listening, welcoming spontaneous demands
and strengthening the bond with the community. As stated by Campos and Domitti (2007), the UBSs
should be privileged spaces for shared care and the construction of therapeutic projects that consider
not only the disease, but the users’ way of life. The analyzed experience showed how the presence of
students can dynamize this process, contributing to the dialogue between academic knowledge and
popular knowledge.
In addition to the immediate results on care, the project revealed potential for replicability
in other territories, especially in communities with similar sociodemographic characteristics. The
systematization of the experience, with a detailed description of the method, instruments and approach,
allows other higher education institutions to replicate the methodology with the appropriate contextual
adjustments. This perspective is in line with the principles of Brazilian university extension, which
advocate the inseparability between teaching, research and extension, and the social feedback of the
100
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
knowledge produced at the university (Brasil, 2018).
The engagement of students in all stages of extension action was also congured as
a transversal training process, capable of fostering listening skills, critical analysis, empathy and
planning in collective health. These competencies are considered central to contemporary medical
education, especially in a public health system such as the Brazilian one, which requires professionals
capable of working as a team, understanding the territory, and building joint solutions with the
community. As Schraiber (2010) points out, training for the SUS requires going beyond technique,
promoting critical, ethical training focused on social commitment.
Thus, the reported action reafrms the pedagogical value of university extension as an active
and contextualized methodology, which favors meaningful learning and contributes to the training of
physicians who are more sensitive to social inequalities. The collective construction of the diagnosis,
anchored in listening and presence in the territory, proved to be a powerful tool not only to identify
health demands, but also to broaden the educational horizons of future professionals.
FINAL CONSIDERATIONS
The experience of participatory diagnosis of hypertensive patients in the Family Health
Strategy, developed in the city of Eunápolis-BA, reafrmed the transformative potential of university
extension as a space for ethical, critical and sensitive training for future doctors. By dialoguing
with users in their real life contexts, the students were able to understand, in depth, the multiple
dimensions of the health-disease process and the concrete challenges faced by people with systemic
arterial hypertension. The territory, more than a scenario, has become a formative subject, revealing
vulnerabilities, powers and meanings that would hardly emerge only in formal teaching environments.
This encounter between technical-scientic knowledge and popular knowledge not only
qualied the care experience, but also promoted a dialogic and horizontal health education. The
students were invited to listen, observe and respect the times, speeches and silences of the users,
101
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
recognizing that care is only effective when it starts from authentic listening and recognition of the
other in their uniqueness. The practices developed during the action showed that it is possible to
intervene in a simple, accessible and powerful way, as long as it is understood that the centrality of
care is in the people and their stories.
It is therefore concluded that actions such as this should be encouraged and systematized as
a structuring part of medical education in Brazil. The inseparability between teaching, research and
extension, when experienced with social responsibility and ethical commitment, contributes not only
to the training of more complete professionals, but to the construction of a fairer society, attentive to
inequalities and committed to the right to health. The SUS, as a public policy of inclusion and care,
needs to be experienced, felt, and defended since graduation, and university extension is, without a
doubt, one of the most powerful paths for this learning.
REFERENCES
ALMEIDA, Jéssica Souza de et al. Systemic arterial hypertension as a public health problem: a view
from primary care. Health and Development Journal, Campo Grande, v. 17, n. 19, p. 27–39, 2021.
Available at: https://revistas.unijui.edu.br/index.php/revisaudeb. Accessed on: 10 jul. 2025.
ALMEIDA FILHO, Naomar. The SUS as a public health policy in Brazil: trajectory, advances and
challenges. Salvador: EDUFBA, 2018.
ANTCZAK, Susan E. Basic Pathophysiology. Rio de Janeiro: Grupo GEN, 2005. Electronic book.
ISBN 978-85-277-2537-8. Available at: https://integrada.minhabiblioteca.com.br/#/books/978-85-
277-2537-8/. Accessed on: 26 set. 2024.
APARECIDO, João Batista. Socioeconomic position in the life course, social mobility, and incidence of
arterial hypertension in ELSA-BRASIL participants. (Dissertation presented to the Graduate Program
in Public Health). Federal University of Minas Gerais. 2014. UFMG Repository. Available at: https://
repositorio.ufmg.br/bitstream/1843/38537/1/Disserta%C3%A7%C3%A3o%20Jos%C3%A9%20
Aparecido%20Soares%20Lopes.pdf. Accessed on: 22 out. 2024.
102
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
AYRES, José Ricardo de Carvalho Mesquita. Care and reconstruction of health practices. Interface
– Comunicação, Saúde, Educação, Botucatu, v. 8, n. 14, p. 73–92, 2004. Available at: https://www.
scielo.br/j/icse/a/jNFBpg8J6MzRcBGt5F6B5tn/abstract/?lang=pt. Accessed on: 20 out. 2024.
BRAZIL. Ministry of Health. Surveillance of Risk and Protective Factors for Chronic Diseases by
Telephone Survey - Vigitel 2023. Brasília: Ministry of Health, 2023. Available at: https://www.gov.br/
saude. Accessed on: 18 out. 2024.
BRAZIL. Ministry of Education. National Council of Education. Chamber of Higher Education.
CNE/CES Resolution No. 3, of June 20, 2014. Establishes National Curriculum Guidelines for the
Undergraduate Course in Medicine. Federal Ofcial Gazette: section 1, Brasília, DF, June 23, 2014.
Available at: http://portal.mec.gov.br. Accessed on: 10 jul. 2025.
BRAZIL. Ministry of Education. Guidelines for extension in Brazilian higher education. Brasília:
MEC/Forproex, 2018. Available at: http://portal.mec.gov.br. Accessed on: 10 jul. 2025.
BARATA, Rita de Cássia Parra. The social representations of users about medical care in basic health
units. Saúde e Sociedade, São Paulo, v. 18, n. 1, p. 95–106, 2009.
BISSACOTTI, A. P.; GULES, A. M.; BLÜMKE, A. C. Territorialization in health: concepts, stages
and identication strategies. Hygeia. Brazilian Journal of Medical and Health Geography, Uberlândia,
v. 15, n. 32, p. 41–53, 2019. doi:10.14393/Hygeia153247115. Available at: https://seer.ufu.br/index.php/
hygeia/article/view/47115. Accessed on: 15 out. 2024.
BRASILEIRO FILHO, Gilberto. Basic histology. 13. ed. Rio de Janeiro: Guanabara Koogan, 2021.
BUENO, Sonia Maria Rolim. Educational actions in primary care: the role of the health professional.
Revista Brasileira de Enfermagem, Brasília, v. 65, n. 2, p. 243–249, 2012.
BUSS, Paulo Marchiori; PELLEGRINI FILHO, Alberto. Health and its social determinants. Physis:
Revista de Saúde Coletiva, Rio de Janeiro, v. 17, n. 1, p. 77–93, 2007.
CHA, Paulo do Carmo. Care and comprehensiveness in primary care: challenges for the expanded
clinic. Revista Ciência & Saúde Coletiva, Rio de Janeiro, v. 17, n. 5, p. 1353–1362, 2012. Available at:
103
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
https://www.scielo.br/j/csc. Accessed on: 10 jul. 2025.
CAMPOS, Gastão Wagner de Souza. A method for the analysis and co-management of collectives.
São Paulo: Hucitec, 2000.
CAMPOS, Gastão Wagner de Souza. Public health reform: the concept of eld of practices and health
policy. Revista Ciência & Saúde Coletiva, Rio de Janeiro, v. 11, n. 2, p. 339–348, 2006.
CAMPOS, Gastão Wagner de Souza; DOMITTI, Ana Carolina. Matrix support and reference team:
a methodology for managing interdisciplinary work in health. Revista Ciência & Saúde Coletiva, Rio
de Janeiro, v. 12, n. 1, p. 225–234, 2007. Available at: https://www.scielo.br/j/csc. Accessed on: 10 jul.
2025.
CECCIM, Ricardo Burg; FEUERWERKER, Laura Camargo Macruz. The quadrilateral of training
for the health area: teaching, management, care and social control. Revista Ciência & Saúde Coletiva,
Rio de Janeiro, v. 9, n. 1, p. 245–267, 2004. Available at: https://www.scielo.br/j/csc. Accessed on: 10
jul. 2025.
CIOSAK, Suely Isabel et al. Senescence and senility: a new paradigm in primary health care. Journal
of the School of Nursing of the University of São Paulo, São Paulo, v. 47, n. 1, p. 94–101, 2013.
Available at: https://www.scielo.br/j/reeusp. Accessed on: 10 jul. 2025.
CARDIOLOGY. Brazilian Society of Cardiology. Brazilian guidelines on arterial hypertension.
Brazilian Archives of Cardiology, São Paulo, v. 114, n. 4, p. 1–83, 2020.
DOMITTI, Ana Carolina et al. Matrix support and reference team: a methodology for managing
interdisciplinary work in health. Interface Magazine, Botucatu, v. 11, n. 23, p. 389–406, 2007.
FEUERWERKER, Laura Camargo Macruz. Techno-assistance models: from repetition to reinvention.
In: PINHEIRO, R.; MATTOS, R. A. (ed.). The meanings of comprehensiveness in health care and
attention. Rio de Janeiro: IMS/UERJ, 2004. p. 221–244.
FIGUEIREDO, Nádia Siqueira et al. Embracement as a guideline for the organization of the work
process in primary care. Saúde e Sociedade, São Paulo, v. 23, n. 4, p. 1116–1129, 2014.
104
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
FRANCO, Túlio Batista. The micropolitics of live work in action. In: PINHEIRO, R.; MATTOS, R.
A. (ed.). Care: the frontiers of comprehensiveness. Rio de Janeiro: Abrasco, 2013.
FREIRE, Paulo. Pedagogy of autonomy: knowledge necessary for educational practice. São Paulo:
Paz e Terra, 1996.
HANUS, João Silva et al. Knowledge of hypertensive patients about the disease and treatment in a
family health unit. Revista de Enfermagem UFPE, Recife, v. 9, n. 6, p. 7854–7861, 2015. Available at:
https://periodicos.ufpe.br/revistas/revistaenfermagem. Accessed on: 10 jul. 2025.
JAIME, Patricia Constante; FIGUEIREDO, Isis Baptista. Promotion of adequate and healthy eating
as a public health action in Brazil. Revista Panamericana de Salud Pública, Washington, DC, v. 36,
n. 1, p. 54–60, 2014. Available at: https://www.scielosp.org/article/rpsp/2014.v36n1/54-60/. Accessed
on: 10 jul. 2025.
JARDIM, Paulo César Brandão Veiga. Arterial hypertension in Brazil: current panorama and
perspectives. Journal of the Brazilian Society of Clinical Medicine, São Paulo, v. 16, n. 1, p. 10–13,
2018.
KLATSKY, Arthur Louis. Impact of socioeconomic factors on cardiovascular disease. American
Journal of Cardiology, PuBMed. v. 96, no. 1, p. 62–65 (2015). Translated by AI. Available at: https://
pmc.ncbi.nlm.nih.gov/articles/PMC2818766/. Accessed on: 17 out. 2024.
LEE, Ga Yeon Hin et al. Medication adherence in hypertensive patients: a systematic review. American
Journal of Preventive Medicine, Amsterdam, v. 54, n. 6, p. 784–794, 2018. Available at: https://www.
ajpmonline.org/article/S0749-3797(18)30001-1/fulltext. Accessed on: 10 jul. 2025.
LEINIG, C. Obesity-Induced Hypertension. Arquivos Brasileiros de Cardiologia, v. 120, n. 7, 1 jul.
2023. Available at: https://www.scielo.br/j/abc/a/pS8KFsZRVtCjH5PJ8snGkVk/?lang=pt#. Accessed
on: 23 out. 2024.
LOYOLA, Ioná P. C. V.; Effects of Himalayan salt intake on blood pressure in hypertensive individuals:
a comparative study. Brazilian Journal of Clinical Nutrition, São Paulo, v. 32, n. 2, p. 112–118, 2018.
MENDES, Eugênio Vilaça. The organization of outpatient care in the SUS: the importance of care
105
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
coordination in primary care. Brasilia: PAHO, 2011.
MORI, G.; FERREIRA DA SILVA, L. Leisure in the elderly: human development and quality of life.
Driving. Journal of Physical Education. UNESP, 2010.Available at: https://www.scielo.br/j/motriz/a/
Zv8S5cpZdpjcXKKzJ9hnCNh/?format=pdf&lang=pt. Accessed on: 26 out. 2024.
MORRISON, D. J.; PRESTON, T. Formation of short chain fatty acids by the gut microbiota and
their impact on human metabolism. Gut Microbes, v. 7, n. 3, p. 189–200, 10 mar. 2016. Translated by:
Ariel Vitoriano Leonel. Available at: https://pubmed.ncbi.nlm.nih.gov/26963409/. Accessed on: 29
out. 2024.
NASCIMENTO, Luciana da Silva et al. Polypharmacy and medication adherence in hypertensive
elderly patients treated in primary health care. Brazilian Journal of Geriatrics and Gerontology, Rio
de Janeiro, v. 22, n. 4, p. e190123, 2019. Available at: https://www.scielo.br/j/rbgg. Accessed on: 10 jul.
2025.
PAIM, Jairnilson Silva. What is the SUS. Rio de Janeiro: Fiocruz, 2013.
PAREDES, S.; RIBEIRO, L. Cortisol: the villain in Metabolic Syndrome?. Journal of the Brazilian
Medical Association, v. 60, n. 1, p. 84–92, fev. 2014.Available at: https://www.scielo.br/j/ramb/a/
QMSk3wB3kFN8pwSVpSmsFdd/Acesso on: 18 out. 2024.
PARRA BARATA, Rita de Cássia. The social representations of users about medical care in basic
health units. Saúde e Sociedade, São Paulo, v. 18, n. 1, p. 95–106, 2009.
PELLEGRINI FILHO, Alberto. Equity and health systems reform. Cadernos de Saúde Pública, Rio
de Janeiro, v. 23, n. 7, p. 1678–1681, 2007.
PIERIN, A. M. G. et al. Prevalence, treatment and control of arterial hypertension in different social
strata. Brazilian Journal of Hypertension, v. 25, p. 9-15, 2018. Available at: https://www.google.
com.br/url?sa=t&source=web&rct=j&opi=89978449&url=http://departamentos.cardiol.br/sbc-dha/
prossional/revista/25-1pdf&ved=2ahUKEwiCvdCv7seJAxWer5UCHYuUIFkQFnoECBMQAQ&us
g=AOvVaw3oms3GA5kEdP6EVAopW4FS. Accessed on: Oct. 18. 2024.
PORTO, Celmo C. Medical Semiology. 8th ed. Rio de Janeiro: Grupo GEN, 2019. Electronic book. ISBN
106
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
9788527734998. Available at: https://integrada.minhabiblioteca.com.br/#/books/9788527734998/.
Accessed on: 26 set. 2024.
RIBEIRO, A. G. et al. Antidepressants: use, adherence and knowledge among medical students.
Ciência & Saúde Coletiva, Rio de Janeiro, v. 19, n. 6, p. 1941–1950, 2014.
RODRIGUES, Tamires da Silva. University extension and health care: listening and bonding practices
in vulnerable territories. Brazilian Journal of Medical Education, Brasília, v. 45, n. 3, p. e110, 2021.
Available at: https://www.scielo.br/j/rbem. Accessed on: 10 jul. 2025.
SANTOS, Maria Helena et al. Social representations of health and disease: contributions to the
humanization of health care. Revista Ciência & Saúde Coletiva, Rio de Janeiro, v. 10, n. 3, p. 505–513,
2005.
SOUZA, João Carlos de. Primary care and organization of work processes in the Family Health
Strategy. Revista Saúde em Debate, Rio de Janeiro, v. 39, n. esp., p. 67–75, 2015. Available at: https://
www.scielo.br/j/sdeb. Accessed on: 10 jul. 2025.
SANJULIANI, Antônio Felipe et al. Arterial hypertension: approach and treatment. Revista Brasileira
de Hipertension, Rio de Janeiro, v. 9, n. 2, p. 121–127, 2002.
SANTIAGO, Mariane Almeida. Educational practices in health and promotion of self-care among
hypertensive patients. Revista Saúde Coletiva, São Paulo, v. 28, n. 1, p. 19–30, 2018.
SCHRAIBER, Lilia Blima; MENDES-GONÇALVES, Roseni Pinheiro. Health practices: work
process and health needs. Revista Saúde em Debate, Rio de Janeiro, v. 42, n. 2, p. 133–146, 2018.
SECRETARY OF HEALTH OF THE STATE OF BAHIA (SESAB). Primary Care Indicator Panel
– 2023. Salvador: Superintendence of Comprehensive Health Care, 2023. Available at: http://www.
saude.ba.gov.br/. Accessed on: 10 jul. 2025.
SILVA, M. F. de S. .; FRANCO, A. G. .; PEREIRA, J. H. .; RIBEIRO, I. V. B. .; FRANCO, A. B.
G. .; FONTES ALVES, C. Hyposalivation and its relationship with antihypertensive medications.
Research, Society and Development, [S. l.], v. 11, n. 12, p. e28111234275, 2022. DOI: 10.33448/rsd-
v11i12.34275. Available at: https://rsdjournal.org/index.php/rsd/article/view/34275. Accessed on: 6
107
ISSN: 2763-5724 / Vol. 05 - n 04 - ano 2025
nov. 2024.
BRAZILIAN SOCIETY OF CARDIOLOGY. 7th Brazilian Guideline on Arterial Hypertension.
Brazilian Archives of Cardiology, São Paulo, v. 107, n. 3, suppl. 3, p. 1-83, 2016. Available at: https://
www.scielo.br/j/abc/a/KVdb6XvFGPJLqHfXKDbNQCG/?format=pdf&lang=pt. Accessed on: 28.
out. 2024.
BRAZILIAN SOCIETY OF CARDIOLOGY. Brazilian Guidelines on Arterial Hypertension – 2020.
Brazilian Archives of Cardiology, São Paulo, v. 116, n. 3, p. 516-658, 2020. Available at: https://www.
scielo.br/j/abc/a/DiretrizesBrasileirasdeHipertensao2020. Accessed on: 18 out. 2024.
SOUZA, João Carlos de. Primary care and organization of work processes in the Family Health
Strategy. Revista Saúde em Debate, Rio de Janeiro, v. 39, n. esp., p. 67–75, 2015.
SOUZA, João Carlos de; SANTIAGO, Mariane Almeida. Educational actions on hypertension in
Primary Care: challenges of the extended clinic. Revista Saúde Coletiva, São Paulo, v. 28, n. 2, p.
103–112, 2018.
STARFIELD, Barbara. Primary care: balance between health needs, services and technology. Brasília:
UNESCO, Ministry of Health, 2002.
VASCONCELOS, Eduardo. Health care model: from the pyramid to the circle. Revista Saúde em
Debate, Rio de Janeiro, v. 32, n. 78/79, p. 219–230, 2008.
