Key result
Novel 11-item screening tool identifies hypertension with modest accuracy in primary care.
Why the study?
Many individuals with systemic arterial hypertension in low- and middle-income countries remain undiagnosed, and a validated brief screening instrument was needed to support early risk identification in Primary Health Care.
Does an 11-item hypertension risk screening questionnaire accurately and reliably identify individuals at greater risk of systemic arterial hypertension in adult Brazilian Primary Health Care users?
Cross-Sectional (n=200)
Yes
Does an 11-item hypertension risk screening questionnaire accurately and reliably identify individuals at greater risk of systemic arterial hypertension in adult Brazilian Primary Health Care users?
This study developed and validated a brief 11-item screening questionnaire that demonstrates satisfactory psychometric validity and moderate discriminatory accuracy (AUC 0.679) to help prioritize adults for blood pressure assessment in Brazilian Primary Health Care settings.
May help prioritize BP assessment in primary care; leaves open impact on detection rates pending prospective validation.
Background Systemic arterial hypertension (SAH) is highly prevalent, but in low- and middle-income countries many individuals remain undiagnosed. In Primary Health Care (PHC), brief screening instruments can support early risk identification. This study aimed to develop and validate a screening instrument for hypertension risk identification among PHC users. Methods A cross-sectional study was conducted in three stages: item development based on national guidelines and epidemiological evidence; content validation by a panel of experts; and field testing with adult PHC users. Construct validity was assessed using exploratory and confirmatory factor analysis; internal consistency was assessed using Cronbach’s α and McDonald’s ω; and classification accuracy was assessed using ROC analysis. Results Twenty-three experts participated in content validation, leading to the reformulation of five items and exclusion of one. Field testing included 200 adult PHC users. The final instrument consisted of eleven items organized into three dimensions: lifestyle, socioeconomic and health conditions, and dietary habits. The three-factor model explained 61.19% of the total variance and presented an adequate fit (CFI = 0.95, TLI = 0.91, RMSEA = 0.06), with acceptable internal consistency (Cronbach’s α = 0.66; McDonald’s ω = 0.67). Higher screening scores were associated with higher blood pressure levels, and a preliminary diagnostic accuracy analysis showed an AUC of 0.679 (95% CI: 0.610–0.743; p < 0.001). Conclusions The screening tool demonstrates satisfactory evidence of validity and reliability. It may represent a simple and practical instrument to support the early identification of individuals at greater risk of hypertension in PHC settings.
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Ferreira et al. (2026) conducted a cross-sectional in Systemic arterial hypertension (n=200). 11-item hypertension screening tool vs. Standardized blood pressure measurement and/or antihypertensive medication use was evaluated on Discriminatory accuracy (AUC) and construct validity of the 11-item screening tool for identifying systemic arterial hypertension (AUC 0.679, 95% CI 0.610-0.743, p=<0.001). The 11-item hypertension screening tool demonstrated adequate construct validity (CFI 0.95, RMSEA 0.06) and discriminatory accuracy for hypertension (AUC 0.679, p<0.001) in primary care users.
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