Development and Validation of a Screening Tool for Hypertension in Primary Health Care Users

Abstract 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.