PRIMARY-HF: Diagnóstico de Insuficiência Cardíaca em Cuidados de Saúde Primários Utilizando Ecografia Point-of-Care e Péptidos Natriuréticos
The goal of this clinical trial is to evaluate whether the use of NT-proBNP testing and point-of-care ultrasound (POCUS) can improve the diagnosis and management of heart failure in adults aged 50 years or older with suspected heart failure or cardiovascular risk factors in primary care settings. The main questions it aims to answer are: * Does the use of NT-proBNP and/or POCUS increase the rate of new heart failure diagnoses compared with standard care? * Does this approach support earlier initiation of guideline-directed medical therapy and improve patients' quality of life? Researchers will compare standard care alone with standard care combined with NT-proBNP testing, POCUS, or both, to assess their impact on diagnosis and management of heart failure. Participants will: * Be randomly assigned to one of four groups (standard care, NT-proBNP, POCUS, or both). * Undergo clinical evaluation for heart failure according to their assigned group. * Be followed for 12 months with periodic assessments of quality of life and treatment adherence.
• Adults aged ≥50 years
• Suspected heart failure (based on signs and/or symptoms) OR
• Presence of at least two cardiovascular risk factors, including:
‣ Diabetes mellitus
⁃ Arterial hypertension
⁃ Estimated glomerular filtration rate (eGFR) \<60 mL/min/1.73 m²
⁃ Albuminuria
⁃ Coronary artery disease or prior myocardial infarction or coronary revascularization
⁃ Stroke or transient ischemic attack
⁃ Atrial fibrillation or flutter
⁃ Left ventricular hypertrophy or Q waves on electrocardiogram
⁃ Obesity (body mass index ≥30 kg/m²)
• Ability to provide written informed consent