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<!DOCTYPE html>     <html class="no-js" lang="en">  <head><META http-equiv="Content-Type" content="text/html; charset=UTF-8"> <meta content="text/html; charset=UTF-8" http-equiv="Content-Type"> <meta content="IE=edge,chrome=1" http-equiv="X-UA-Compatible"> <meta content="width=device-width,initial-scale=1" name="viewport"> <link rel="shortcut icon" href="/themes/Mirage2PAHO/images/favicon.ico"> <link rel="apple-touch-icon" href="/themes/Mirage2PAHO/images/apple-touch-icon.png"> <meta name="Generator" content="DSpace 6.4-SNAPSHOT"> <link href="/themes/Mirage2PAHO/styles/main.css" rel="stylesheet"> <link type="application/opensearchdescription+xml" rel="search" href="https://iris.paho.org:443/open-search/description.xml" title="DSpace"> <script> //Clear default text of empty text areas on focus function tFocus(element) { if (element.value == ' '){element.value='';} } //Clear default text of empty text areas on submit function tSubmit(form) { var defaultedElements = document.getElementsByTagName("textarea"); for (var i=0; i != defaultedElements.length; i++){ if (defaultedElements[i].value == ' '){ defaultedElements[i].value='';}} } //Disable pressing 'enter' key to submit a form (otherwise pressing 'enter' causes a submission to start over) function disableEnterKey(e) { var key; if(window.event) key = window.event.keyCode; //Internet Explorer else key = e.which; //Firefox and Netscape if(key == 13) //if "Enter" pressed, then disable! return false; else return true; } </script><script src="/themes/Mirage2PAHO/vendor/modernizr/modernizr.js"> </script><script crossorigin="anonymous" src="https://kit.fontawesome.com/20eac3219c.js"></script> <title>Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala</title> <link rel="schema.DCTERMS" href="http://purl.org/dc/terms/" /> <link rel="schema.DC" href="http://purl.org/dc/elements/1.1/" /> <meta name="DC.creator" content="Wellmann, Irmgardt Alicia" /> <meta name="DC.creator" content="Rodríguez, José Javier" /> <meta name="DC.creator" content="Batzin, Benilda" /> <meta name="DC.creator" content="Hegel, Guillermo" /> <meta name="DC.creator" content="Ayala, Luis Fernando" /> <meta name="DC.creator" content="Ozano, Kim" /> <meta name="DC.creator" content="Fort, Meredith P." /> <meta name="DC.creator" content="Flores, Walter" /> <meta name="DC.creator" content="Ramirez, Lesly" /> <meta name="DC.creator" content="Palacios, Eduardo" /> <meta name="DC.creator" content="Martínez, Mayron" /> <meta name="DC.creator" content="Ramirez-Zea, Manuel" /> <meta name="DC.creator" content="Flood, David" /> <meta name="DCTERMS.dateAccepted" content="2024-10-11T15:08:18Z" scheme="DCTERMS.W3CDTF" /> <meta name="DCTERMS.available" content="2024-10-11T15:08:18Z" scheme="DCTERMS.W3CDTF" /> <meta name="DCTERMS.issued" content="2024-10-18" scheme="DCTERMS.W3CDTF" /> <meta name="DCTERMS.bibliographicCitation" content="Wellmann IA, Rodríguez JJ, Batzin B, Hegel G, Ayala LF, Ozano K, et al. Reach and effectiveness of a HEARTS hypertension
pilot project in Guatemala. Rev Panam Salud Publica. 2024;48:e100. https://doi.org/10.26633/RPSP.2024.100" xml:lang="en_US" /> <meta name="DC.identifier" content="1680 5348" /> <meta name="DC.identifier" content="https://iris.paho.org/handle/10665.2/61827" scheme="DCTERMS.URI" /> <meta name="DCTERMS.abstract" content="[ABSTRACT]. The World Health Organization Global Hearts initiative (HEARTS) and technical package aim to improve the
primary health care management of hypertension and other risk factors for cardiovascular disease at the
population level. This study describes the first HEARTS implementation pilot project in Guatemala’s Ministry
of Health (MOH) primary health care system. This pilot began in April 2022 in six primary health care facilities in three rural indigenous municipalities. The project consisted of HEARTS-aligned strategies adapted to
enhance program sustainability in Guatemala. Outcomes were defined using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. The primary reach outcome was treatment count,
defined as the absolute number of patients per month receiving medication treatment for hypertension. The
primary effectiveness outcomes were mean systolic blood pressure (BP), mean diastolic BP, and proportion
of patients with BP control (<130/80 mmHg). In the first month of the post-implementation period, there was
a statistically significant increase of 25 patients treated per month above the baseline of 20 to 25 patients
(P = .002), followed by a significant increase of 2.4 additional patients treated each month (P = .005) thereafter.
The mean change in systolic BP was −4.4 (95% CI, −8.2 to −0.5; P = 0.028) mmHg, and the mean change
in diastolic BP was −0.9 (95% CI, −2.8 to 1.1; P = .376) mmHg. The proportion of the cohort with BP control
increased from 33.4% at baseline to 47.1% at 6 months (adjusted change, 13.7%; 95% CI, 2.2% to 25.2%;
P = .027). These findings support the feasibility of implementing the HEARTS model for BP control throughout
the MOH primary health care system, which is where most Guatemalans with hypertension seek care." xml:lang="en_US" /> <meta name="DCTERMS.abstract" content="[RESUMEN]. El paquete técnico de la Iniciativa Global Hearts ("HEARTS") de la Organización Mundial de la Salud tiene como
objetivo mejorar el control de la hipertensión y de otros factores de riesgo de enfermedades cardiovasculares
a nivel poblacional en el ámbito de la atención primaria de salud de salud. Este estudio describe el primer
proyecto piloto de implementación de HEARTS en el sistema de atención primaria de salud del Ministerio
de Salud de Guatemala. El proyecto, que comenzó en abril del 2022 en seis centros de atención primaria
de salud pertenecientes a tres municipios rurales indígenas, consistió en estrategias alineadas con HEARTS
y adaptadas para mejorar la sostenibilidad del programa en Guatemala. Los criterios de valoración de los
resultados se definieron mediante el marco estandarizado de evaluación de cobertura, efectividad, adopción,
implementación y mantenimiento (RE-AIM, por su sigla en inglés). El criterio principal de la cobertura fue la
cantidad de tratamientos, definida como el número absoluto de pacientes por mes que recibían tratamiento farmacológico para la hipertensión. Los criterios principales de la efectividad fueron la media de presión arterial
(PA) sistólica, la media de PA diastólica y la proporción de pacientes con un control de la PA (<130/80 mmHg).
En el primer mes del período posterior a la implementación, se registró un aumento estadísticamente significativo de 25 pacientes tratados al mes por encima del valor inicial de 20 a 25 pacientes (n = 25; p = 0,002),
seguido de un aumento significativo de 2,4 pacientes adicionales tratados al mes (p = 0,005) posteriormente.
El cambio en la media de la PA sistólica fue de -4,4 (IC del 95%: -8,2 a -0,5); p = 0,028) mmHg, en tanto que el
cambio en la media de la PA diastólica fue de -0,9 (IC del 95%, -2,8 a 1,1); p = 0,376) mmHg. La proporción de
la cohorte con control de la PA aumentó del 33,4% al inicio al 47,1% a los seis meses (cambio ajustado, 13,7%;
IC del 95%, 2,2% a 25,2%; p = 0,027). Estos resultados respaldan la viabilidad de la implementación del modelo HEARTS para el control de la PA en la totalidad del sistema de atención primaria de salud del Ministerio de
Salud de Guatemala, al que acude en busca de atención la mayoría de las personas con hipertensión." xml:lang="en_US" /> <meta name="DCTERMS.abstract" content="[RESUMO]. O pacote de medidas técnicas da iniciativa Global Hearts (“HEARTS”) da Organização Mundial da Saúde tem
como objetivo melhorar o controle da hipertensão arterial e de outros fatores de risco para doenças cardiovasculares na atenção primária à saúde em nível populacional. Este estudo descreve o primeiro projeto-piloto
de implementação da iniciativa HEARTS no sistema de atenção primária à saúde do Ministério da Saúde
da Guatemala. O projeto-piloto começou em abril de 2022 em seis estabelecimentos de atenção primária à
saúde em três municípios indígenas rurais. O projeto consistiu em estratégias alinhadas à iniciativa HEARTS
e adaptadas para melhorar a sustentabilidade do programa na Guatemala. Os desfechos foram definidos
usando a estrutura de avaliação RE-AIM (sigla em inglês para alcance, efetividade, adoção, implementação
e manutenção). O desfecho primário de alcance foi a quantidade de tratamentos, definida como o número
absoluto de pacientes por mês que receberam tratamento medicamentoso para hipertensão. Os desfechos
primários de efetividade foram pressão arterial (PA) sistólica média, PA diastólica média e proporção de
pacientes com controle da PA (<130/80 mmHg). No primeiro mês do período pós-implementação, houve um
aumento estatisticamente significante de 25 pacientes tratados por mês acima da linha de base de 20 a 25
pacientes (n = 25; P = 0,002), seguido de um aumento significante de 2,4 pacientes adicionais tratados a
cada mês (P = 0,005) depois disso. A mudança média na PA sistólica foi de −4,4 (intervalo de confiança [IC]
de 95%: −8,2 a −0,5; P = 0,028) mmHg, e a mudança média na PA diastólica foi de −0,9 (IC de 95%: −2,8
a 1,1; P = 0,376) mmHg. A proporção da coorte com controle da PA aumentou de 33,4% na linha de base
para 47,1% após 6 meses (mudança ajustada, 13,7%; IC de 95%: 2,2% a 25,2%; P = 0,027). Esses achados
apoiam a viabilidade da implementação do modelo HEARTS para o controle da PA em todo o sistema de
atenção primária à saúde do Ministério da Saúde da Guatemala, no qual a maioria dos indivíduos com hipertensão arterial procura atendimento." xml:lang="en_US" /> <meta name="DC.language" content="en" xml:lang="en_US" scheme="DCTERMS.RFC1766" /> <meta name="DC.relation" content="Rev Panam Salud Publica;48, oct. 2024" /> <meta name="DC.rights" content="Attribution-NonCommercial-NoDerivs 3.0 IGO" xml:lang="*" /> <meta name="DC.rights" content="http://creativecommons.org/licenses/by-nc-nd/3.0/igo/" xml:lang="*" scheme="DCTERMS.URI" /> <meta name="DC.subject" content="Hypertension" xml:lang="en_US" /> <meta name="DC.subject" content="Implementation Science" xml:lang="en_US" /> <meta name="DC.subject" content="Global Health" xml:lang="en_US" /> <meta name="DC.subject" content="Health Policy" xml:lang="en_US" /> <meta name="DC.subject" content="Guatemala" xml:lang="en_US" /> <meta name="DC.subject" content="Hipertensión" xml:lang="en_US" /> <meta name="DC.subject" content="Ciencia de la Implementación" xml:lang="en_US" /> <meta name="DC.subject" content="Salud Global" xml:lang="en_US" /> <meta name="DC.subject" content="Política de Salud" xml:lang="en_US" /> <meta name="DC.subject" content="Hipertensão" xml:lang="en_US" /> <meta name="DC.subject" content="Ciência da Implementação" xml:lang="en_US" /> <meta name="DC.subject" content="Saúde Global" xml:lang="en_US" /> <meta name="DC.subject" content="Política de Saúde" xml:lang="en_US" /> <meta name="DC.title" content="Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala" xml:lang="en_US" /> <meta name="DCTERMS.alternative" content="Cobertura y efectividad de un proyecto piloto HEARTS para el control de la hipertensión en Guatemala" xml:lang="en_US" /> <meta name="DCTERMS.alternative" content="Alcance e efetividade de um projeto piloto de controle da hipertensão arterial da iniciativa HEARTS na Guatemala" xml:lang="en_US" /> <meta name="DC.type" content="Journal articles" xml:lang="en_US" /> <meta name="DC.rights" content="Pan American Health Organization" xml:lang="en_US" /> <meta name="DC.identifier" content="https://doi.org/10.26633/RPSP.2024.100" /> <meta name="DC.relation" content="Revista Panamericana de Salud Pública" xml:lang="es_ES" /> <meta name="DC.relation" content="Pan American Journal of Public Health" /> <meta content="Hypertension; Implementation Science; Global Health; Health Policy; Guatemala; Hipertensión; Ciencia de la Implementación; Salud Global; Política de Salud; Hipertensão; Ciência da Implementação; Saúde Global; Política de Saúde; Journal articles" name="citation_keywords"> <meta content="Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala" name="citation_title"> <meta content="1680 5348" name="citation_issn"> <meta content="https://doi.org/10.26633/RPSP.2024.100" name="citation_doi"> <meta content="en" name="citation_language"> <meta content="Rev Panam Salud Publica;48, oct. 2024" name="citation_journal_title"> <meta content="Wellmann, Irmgardt Alicia" name="citation_author"> <meta content="Rodríguez, José Javier" name="citation_author"> <meta content="Batzin, Benilda" name="citation_author"> <meta content="Hegel, Guillermo" name="citation_author"> <meta content="Ayala, Luis Fernando" name="citation_author"> <meta content="Ozano, Kim" name="citation_author"> <meta content="Fort, Meredith P." name="citation_author"> <meta content="Flores, Walter" name="citation_author"> <meta content="Ramirez, Lesly" name="citation_author"> <meta content="Palacios, Eduardo" name="citation_author"> <meta content="Martínez, Mayron" name="citation_author"> <meta content="Ramirez-Zea, Manuel" name="citation_author"> <meta content="Flood, David" name="citation_author"> <meta content="https://iris.paho.org/bitstream/10665.2/61827/1/v48e1002024.pdf" name="citation_pdf_url"> <meta content="2024-10-18" name="citation_date"> <meta content="https://iris.paho.org/handle/10665.2/61827" name="citation_abstract_html_url"> 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class="item-summary-view-metadata"> <h2 class="page-header first-page-header">Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala</h2> <div class="row"> <div class="col-sm-4"> <div class="row"> <div class="col-xs-6 col-sm-12"> <div class="thumbnail"> <img alt="Thumbnail" class="img-thumbnail" src="/bitstream/handle/10665.2/61827/v48e1002024.pdf.jpg?sequence=4&isAllowed=y"></div> </div> <div class="col-xs-6 col-sm-12"> <div class="item-page-field-wrapper table word-break"> <h5>View/<wbr></wbr>Open</h5> <div> <a href="/bitstream/handle/10665.2/61827/v48e1002024.pdf?sequence=1&isAllowed=y" target="_blank"><i aria-hidden="true" class="glyphicon glyphicon-file"></i> v48e1002024.pdf (555.9Kb)</a> </div> </div> </div> <div class="col-xs-6 col-sm-12 item-view-export-buttons"> <div class="btn-group sort-export-menu"> <button data-toggle="dropdown" class="btn btn-default dropdown-toggle export-button" type="button"><span aria-hidden="true" class="fa 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Benilda</a> </div> <div> <a href="../../browse?value=Hegel, Guillermo&type=author">Hegel, Guillermo</a> </div> <div> <a href="../../browse?value=Ayala, Luis Fernando&type=author">Ayala, Luis Fernando</a> </div> <div> <a href="../../browse?value=Ozano, Kim&type=author">Ozano, Kim</a> </div> <div> <a href="../../browse?value=Fort, Meredith P.&type=author">Fort, Meredith P.</a> </div> <div> <a href="../../browse?value=Flores, Walter&type=author">Flores, Walter</a> </div> <div> <a href="../../browse?value=Ramirez, Lesly&type=author">Ramirez, Lesly</a> </div> <div> <a href="../../browse?value=Palacios, Eduardo&type=author">Palacios, Eduardo</a> </div> <div> <a href="../../browse?value=Mart%C3%ADnez, Mayron&type=author">Martínez, Mayron</a> </div> <div> <a href="../../browse?value=Ramirez-Zea, Manuel&type=author">Ramirez-Zea, Manuel</a> </div> <div> <a href="../../browse?value=Flood, David&type=author">Flood, David</a> </div> </div> <div class="simple-item-view-show-full item-page-field-wrapper table"> <h5>Metadata</h5> <a href="/handle/10665.2/61827?show=full">Show full item record</a> </div> </div> <div class="col-sm-8"> <div class="simple-item-view-description item-page-field-wrapper table"> <h5 class="visible-xs">Abstract</h5> <div>[ABSTRACT]. The World Health Organization Global Hearts initiative (HEARTS) and technical package aim to improve the primary health care management of hypertension and other risk factors for cardiovascular disease at the population level. This study describes the first HEARTS implementation pilot project in Guatemala’s Ministry of Health (MOH) primary health care system. This pilot began in April 2022 in six primary health care facilities in three rural indigenous municipalities. The project consisted of HEARTS-aligned strategies adapted to enhance program sustainability in Guatemala. Outcomes were defined using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. The primary reach outcome was treatment count, defined as the absolute number of patients per month receiving medication treatment for hypertension. The primary effectiveness outcomes were mean systolic blood pressure (BP), mean diastolic BP, and proportion of patients with BP control (<130/80 mmHg). In the first month of the post-implementation period, there was a statistically significant increase of 25 patients treated per month above the baseline of 20 to 25 patients (P = .002), followed by a significant increase of 2.4 additional patients treated each month (P = .005) thereafter. The mean change in systolic BP was −4.4 (95% CI, −8.2 to −0.5; P = 0.028) mmHg, and the mean change in diastolic BP was −0.9 (95% CI, −2.8 to 1.1; P = .376) mmHg. The proportion of the cohort with BP control increased from 33.4% at baseline to 47.1% at 6 months (adjusted change, 13.7%; 95% CI, 2.2% to 25.2%; P = .027). These findings support the feasibility of implementing the HEARTS model for BP control throughout the MOH primary health care system, which is where most Guatemalans with hypertension seek care.<div class="spacer"> </div>[RESUMEN]. El paquete técnico de la Iniciativa Global Hearts ("HEARTS") de la Organización Mundial de la Salud tiene como objetivo mejorar el control de la hipertensión y de otros factores de riesgo de enfermedades cardiovasculares a nivel poblacional en el ámbito de la atención primaria de salud de salud. Este estudio describe el primer proyecto piloto de implementación de HEARTS en el sistema de atención primaria de salud del Ministerio de Salud de Guatemala. El proyecto, que comenzó en abril del 2022 en seis centros de atención primaria de salud pertenecientes a tres municipios rurales indígenas, consistió en estrategias alineadas con HEARTS y adaptadas para mejorar la sostenibilidad del programa en Guatemala. Los criterios de valoración de los resultados se definieron mediante el marco estandarizado de evaluación de cobertura, efectividad, adopción, implementación y mantenimiento (RE-AIM, por su sigla en inglés). El criterio principal de la cobertura fue la cantidad de tratamientos, definida como el número absoluto de pacientes por mes que recibían tratamiento farmacológico para la hipertensión. Los criterios principales de la efectividad fueron la media de presión arterial (PA) sistólica, la media de PA diastólica y la proporción de pacientes con un control de la PA (<130/80 mmHg). En el primer mes del período posterior a la implementación, se registró un aumento estadísticamente significativo de 25 pacientes tratados al mes por encima del valor inicial de 20 a 25 pacientes (n = 25; p = 0,002), seguido de un aumento significativo de 2,4 pacientes adicionales tratados al mes (p = 0,005) posteriormente. El cambio en la media de la PA sistólica fue de -4,4 (IC del 95%: -8,2 a -0,5); p = 0,028) mmHg, en tanto que el cambio en la media de la PA diastólica fue de -0,9 (IC del 95%, -2,8 a 1,1); p = 0,376) mmHg. La proporción de la cohorte con control de la PA aumentó del 33,4% al inicio al 47,1% a los seis meses (cambio ajustado, 13,7%; IC del 95%, 2,2% a 25,2%; p = 0,027). Estos resultados respaldan la viabilidad de la implementación del modelo HEARTS para el control de la PA en la totalidad del sistema de atención primaria de salud del Ministerio de Salud de Guatemala, al que acude en busca de atención la mayoría de las personas con hipertensión.<div class="spacer"> </div>[RESUMO]. O pacote de medidas técnicas da iniciativa Global Hearts (“HEARTS”) da Organização Mundial da Saúde tem como objetivo melhorar o controle da hipertensão arterial e de outros fatores de risco para doenças cardiovasculares na atenção primária à saúde em nível populacional. Este estudo descreve o primeiro projeto-piloto de implementação da iniciativa HEARTS no sistema de atenção primária à saúde do Ministério da Saúde da Guatemala. O projeto-piloto começou em abril de 2022 em seis estabelecimentos de atenção primária à saúde em três municípios indígenas rurais. O projeto consistiu em estratégias alinhadas à iniciativa HEARTS e adaptadas para melhorar a sustentabilidade do programa na Guatemala. Os desfechos foram definidos usando a estrutura de avaliação RE-AIM (sigla em inglês para alcance, efetividade, adoção, implementação e manutenção). O desfecho primário de alcance foi a quantidade de tratamentos, definida como o número absoluto de pacientes por mês que receberam tratamento medicamentoso para hipertensão. Os desfechos primários de efetividade foram pressão arterial (PA) sistólica média, PA diastólica média e proporção de pacientes com controle da PA (<130/80 mmHg). No primeiro mês do período pós-implementação, houve um aumento estatisticamente significante de 25 pacientes tratados por mês acima da linha de base de 20 a 25 pacientes (n = 25; P = 0,002), seguido de um aumento significante de 2,4 pacientes adicionais tratados a cada mês (P = 0,005) depois disso. A mudança média na PA sistólica foi de −4,4 (intervalo de confiança [IC] de 95%: −8,2 a −0,5; P = 0,028) mmHg, e a mudança média na PA diastólica foi de −0,9 (IC de 95%: −2,8 a 1,1; P = 0,376) mmHg. A proporção da coorte com controle da PA aumentou de 33,4% na linha de base para 47,1% após 6 meses (mudança ajustada, 13,7%; IC de 95%: 2,2% a 25,2%; P = 0,027). Esses achados apoiam a viabilidade da implementação do modelo HEARTS para o controle da PA em todo o sistema de atenção primária à saúde do Ministério da Saúde da Guatemala, no qual a maioria dos indivíduos com hipertensão arterial procura atendimento.<div class="spacer"> </div> </div> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Pages</h5> <div>6 p.</div> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Volume</h5> <div>48</div> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Translated title</h5> <div>Cobertura y efectividad de un proyecto piloto HEARTS para el control de la hipertensión en Guatemala<div class="spacer"> </div>Alcance e efetividade de um projeto piloto de controle da hipertensão arterial da iniciativa HEARTS na Guatemala<div class="spacer"> </div> </div> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Series</h5> <div> <a href="../../browse?value=Rev Panam Salud Publica;48, oct. 2024&type=serie">Rev Panam Salud Publica;48, oct. 2024</a> </div> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Subject</h5> <div> <a href="../../browse?value=Hypertension&type=subject">Hypertension</a>; <a href="../../browse?value=Implementation Science&type=subject">Implementation Science</a>; <a href="../../browse?value=Global Health&type=subject">Global Health</a>; <a href="../../browse?value=Health Policy&type=subject">Health Policy</a>; <a href="../../browse?value=Guatemala&type=subject">Guatemala</a>; <a href="../../browse?value=Hipertensi%C3%B3n&type=subject">Hipertensión</a>; <a href="../../browse?value=Ciencia de la Implementaci%C3%B3n&type=subject">Ciencia de la Implementación</a>; <a href="../../browse?value=Salud Global&type=subject">Salud Global</a>; <a href="../../browse?value=Pol%C3%ADtica de Salud&type=subject">Política de Salud</a>; <a href="../../browse?value=Hipertens%C3%A3o&type=subject">Hipertensão</a>; <a href="../../browse?value=Ci%C3%AAncia da Implementa%C3%A7%C3%A3o&type=subject">Ciência da Implementação</a>; <a href="../../browse?value=Sa%C3%BAde Global&type=subject">Saúde Global</a>; <a href="../../browse?value=Pol%C3%ADtica de Sa%C3%BAde&type=subject">Política de Saúde</a> </div> </div> <div class="simple-item-view-uri item-page-field-wrapper table"> <h5>URI</h5> <span><a href="https://iris.paho.org/handle/10665.2/61827">https://iris.paho.org/handle/10665.2/61827</a></span> </div> <div class="simple-item-view-description item-page-field-wrapper table"> <h5>Citation</h5> <div>Wellmann IA, Rodríguez JJ, Batzin B, Hegel G, Ayala LF, Ozano K, et al. Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala. Rev Panam Salud Publica. 2024;48:e100. https://doi.org/10.26633/RPSP.2024.100</div> </div> <div class="simple-item-view-collections item-page-field-wrapper table"> <h5>Collections</h5> <ul class="ds-referenceSet-list">  <li> <a href="/handle/10665.2/3028">Pan American Journal of Public Health</a> </li> </ul> </div> </div> </div> </div> <p id="com_atmire_app_xmlui_aspect_citations_ItemCitationTransformer_p_hidden-fields" class="ds-paragraph hidden"> <input id="com_atmire_app_xmlui_aspect_citations_ItemCitationTransformer_field_citation-export-base" class="ds-hidden-field form-control" name="citation-export-base" type="hidden" value="https://iris.paho.org/discover/citation-export?itemUuid=7988e934-d27e-4841-9af6-6dfebca24574"> </p> </div> <div class="row" about="https://iris.paho.org/handle/10665.2/61827"> <div class="col-sm-3 col-xs-12"> <a title="Attribution-NonCommercial-NoDerivs 3.0 IGO" alt="Attribution-NonCommercial-NoDerivs 3.0 IGO" href="http://creativecommons.org/licenses/by-nc-nd/3.0/igo/" rel="license"><img class="img-responsive" src="/themes/Mirage2PAHO//images/creativecommons/cc-by-nc-nd.png" alt="Attribution-NonCommercial-NoDerivs 3.0 IGO"></a> </div> <div class="col-sm-8"> <span>This notice should be preserved along with the article's original URL.Attribution-NonCommercial-NoDerivs 3.0 IGO</span> </div> </div> <div id="aspect_discovery_RelatedItems_div_item-related-container" class="ds-static-div"> <h2 class="ds-div-head page-header">Related items</h2> <div id="aspect_discovery_RelatedItems_div_item-related" class="ds-static-div secondary related"> <p class="ds-paragraph">Showing items related by title, author, creator and subject.</p> <ul class="ds-artifact-list list-unstyled">  <li class="ds-artifact-item odd"> <div class="item-wrapper row"> <div class="col-sm-3 hidden-xs"> <div class="thumbnail artifact-preview"> <a href="/handle/10665.2/59322" class="image-link"><img alt="Thumbnail" class="img-responsive" src="/bitstream/handle/10665.2/59322/v48e172024.pdf.jpg?sequence=4&isAllowed=y"></a> </div> </div> <div class="col-sm-9"> <div class="col-sm-11 col-xs-11 artifact-description browse-export-feature"> <div class="artifact-title"> <a href="/handle/10665.2/59322">HEARTS en las Américas: impulsar el cambio en el sistema de salud para mejorar el control de la hipertensión en la población</a><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft_id=1680+5348&rft_id=https%3A%2F%2Firis.paho.org%2Fhandle%2F10665.2%2F59322&rft_id=https%3A%2F%2Fdoi.org%2F10.26633%2FRPSP.2024.17&rfr_id=info%3Asid%2Fdspace.org%3Arepository&rft.source=US1.1&rft.journal=48"> </span> </div> <div class="artifact-info"> <span class="author"><span>Ordunez, Pedro</span>; <span>Campbell, Norm R. 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Con el propósito de describir los cambios en el control de la hipertensión arterial desde 2016 a 2021 y la relación de los progresos con la madurez de implementación de la Iniciativa HEARTS en el primer nivel ...</div> </div> </div> </div> </li> </ul> </div> </div> </div> </div> <div role="navigation" id="sidebar" class="col-xs-6 col-sm-3 sidebar-offcanvas"> <div class="word-break hidden-print" id="ds-options"> <div class="ds-option-set" id="ds-search-option"> <form method="post" class="" id="ds-search-form" action="/discover"> <fieldset> <div class="input-group"> <input placeholder="Insert your search here or click on zoom to use filters" type="text" class="ds-text-field form-control" name="query"><span class="input-group-btn"><button title="Go" class="ds-button-field btn btn-primary"><span aria-hidden="true" class="glyphicon glyphicon-search"></span></button></span> </div> <div class="radio"> <label><input checked value="" name="scope" type="radio" id="ds-search-form-scope-all">Search Repository</label> </div> <div class="radio"> <label><input name="scope" type="radio" id="ds-search-form-scope-container" value="10665.2/3028">This Collection</label> </div> </fieldset> </form> </div> <div id="aspect_discovery_Navigation_list_discovery" class="list-group"></div> <h2 class="ds-option-set-head h6">Browse</h2> <div id="aspect_viewArtifacts_Navigation_list_browse" class="list-group"> <a class="list-group-item active"><span class="h5 list-group-item-heading h5">All of IRIS PAHO</span></a><a href="/community-list" class="list-group-item ds-option">Communities & Collections</a><a href="/browse?type=dateissued" class="list-group-item ds-option">By Issue Date</a><a href="/browse?type=author" class="list-group-item ds-option">Authors</a><a href="/browse?type=title" class="list-group-item ds-option">Titles</a><a href="/browse?type=subject" class="list-group-item ds-option">Subjects</a><a href="/browse?type=serie" class="list-group-item ds-option">Series Title</a><a href="/browse?type=type" class="list-group-item ds-option">Type of material</a><a href="/browse?type=language" class="list-group-item ds-option">Language</a><a href="/browse?type=category" class="list-group-item ds-option">Category</a><a href="/browse?type=department" class="list-group-item ds-option">Technical Unit/Country Office</a><a class="list-group-item active"><span class="h5 list-group-item-heading h5">This Collection</span></a><a href="/handle/10665.2/3028/browse?type=dateissued" class="list-group-item ds-option">By Issue Date</a><a href="/handle/10665.2/3028/browse?type=author" class="list-group-item ds-option">Authors</a><a href="/handle/10665.2/3028/browse?type=title" class="list-group-item ds-option">Titles</a><a href="/handle/10665.2/3028/browse?type=subject" class="list-group-item ds-option">Subjects</a><a href="/handle/10665.2/3028/browse?type=serie" class="list-group-item ds-option">Series Title</a><a href="/handle/10665.2/3028/browse?type=type" class="list-group-item ds-option">Type of material</a><a href="/handle/10665.2/3028/browse?type=language" class="list-group-item ds-option">Language</a><a href="/handle/10665.2/3028/browse?type=category" class="list-group-item ds-option">Category</a><a href="/handle/10665.2/3028/browse?type=department" class="list-group-item ds-option">Technical Unit/Country Office</a> </div> <div id="aspect_viewArtifacts_Navigation_list_account" class="list-group"></div> <div id="aspect_viewArtifacts_Navigation_list_context" class="list-group"></div> <div id="aspect_viewArtifacts_Navigation_list_administrative" class="list-group"></div> <h2 class="ds-option-set-head h6">Statistics</h2> <div id="aspect_statistics_Navigation_list_statistics" class="list-group"> <a href="/handle/10665.2/61827/statistics" class="list-group-item ds-option">View Usage Statistics</a> </div> </div> </div> </div> </div> </div> <footer> <div class="container-fluid azul"> <div class="container"> <div class="flexrow rowfooter"> <div class="footermid"> <img src="/themes/Mirage2PAHO//images/PAHO_logos_left_white_en.png"><br>Pan American Health Organization<br>World Health Organization. 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