Hypertension in Brazil’s Indigenous adults shows strikingly uneven prevalence, review finds

A systematic review and meta-analysis published in BMC Cardiovascular Disorders reports that hypertension prevalence among Indigenous adults in Brazil varies enormously from population to population, with a pooled estimate of 8.2 percent but a prediction interval stretching from nearly zero to more than 70 percent. The open-access study, published on 27 October 2026, was led by Orlando Vieira Gomes and colleagues and registered in PROSPERO (CRD42024626440).

The research team searched five databases without language restrictions for population-based cross-sectional studies reporting hypertension prevalence among Indigenous adults in Brazil. Two reviewers independently carried out study selection and data extraction. In total, twenty-two studies conducted between 1989 and 2024 were included in the systematic review, covering 9,449 Indigenous adults.

For the primary meta-analysis, the authors applied predefined diagnostic criteria. Seventeen population-specific estimates met these criteria, comprising 5,908 individuals, of whom 1,209 had hypertension. Random-effects models were used to estimate pooled prevalence, and subgroup analyses and meta-regression were conducted to explore sources of heterogeneity.

The pooled hypertension prevalence was 8.2 percent, with a 95 percent confidence interval of 3.9 to 16.4 percent. Between-estimate heterogeneity was substantial, with an I-squared value of 94.3 percent, and the 95 percent prediction interval ranged from 0.3 to 73.2 percent, indicating that the true prevalence in individual populations could plausibly fall anywhere within that very wide range.

Age emerged as a key factor in the observed variation. Studies in which the mean age of participants was 40 years or older showed a pooled prevalence of 19.5 percent, compared with 3.6 percent in studies where the mean age was below 40 years. Meta-regression identified year of data collection and mean age as significant moderators, explaining 39.1 percent and 17.1 percent of the between-estimate heterogeneity, respectively.

Geographic region and area of residence were not significant moderators in the analysis. The authors note that the substantial heterogeneity and incomplete reporting of relevant population characteristics limited the interpretation of contextual factors, so the results should not be read as population-level regional estimates or as evidence of an independent effect of urbanization.

In the study’s background, the authors describe hypertension as a major public health issue with increasing prevalence among Brazilian Indigenous adults, and note that social and structural factors, including urbanization and access to healthcare, may play an important role in shaping cardiovascular risk in these populations. The study was designed to systematically assess hypertension prevalence and explore patterns across different populations.

The authors caution in their conclusion that although differences were observed according to age, geographic context, and study period, substantial heterogeneity and methodological limitations restrict causal inference and precise estimation of hypertension prevalence across all Brazilian Indigenous populations. The findings, they write, highlight the need for standardized, culturally sensitive research and context-specific public health strategies addressing hypertension prevention, screening, management, and health disparities.

As an early-access article shared ahead of the final version of record, the publisher notes that the paper is citable and carries a permanent DOI, but remains subject to further edits. The full open-access article, including the complete list of included studies and methodological detail, is available in BMC Cardiovascular Disorders.

Subject of Research: Hypertension prevalence among Indigenous adults in Brazil, assessed through a systematic review and meta-analysis.

Article Title: Heterogeneous burden of hypertension among Brazilian indigenous populations: a systematic review and meta-analysis

Article References: Gomes, O. V., Nicacio, J. M., Amorim, V. D., de Matos Júnior, H. R., da Aguiar Gomes, L. G., da Rocha Araújo, H. S., da Silva, J. G. G., da Cruz, E. G. A., do Carmo, R. F., da Costa Armstrong, A., & de Souza, C. D. F. (2026). Heterogeneous burden of hypertension among Brazilian indigenous populations: a systematic review and meta-analysis. BMC Cardiovascular Disorders. https://doi.org/10.1186/s12872-026-06886-3

Image Credits: AI Generated

DOI: 10.1186/s12872-026-06886-3

Keywords: hypertension, Brazil, Indigenous health, systematic review, meta-analysis, cardiovascular risk, public health, prevalence, heterogeneity, cross-sectional studies, BMC Cardiovascular Disorders, Heterogeneous