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Article History

Received: 27 May 2025

Accepted: 11 August 2025

First Online: 6 October 2025

Declarations

:

: This study complied with the World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. For this study, a submission to an Institutional Review Board was deemed unnecessary.The conclusion is based on the fact that we analysed data collected from two sources. The first source is secondary data from the BRAHIT project, approved by the National Institute of Cardiology (registration no. 5272), the Health Department of the Rio de Janeiro municipality (no. 5279), and Brazil’s National Ethics Committee (no. 8000) under application number 14894819.5.0000.5272. For this source, the informed consent contemplates secondary analysis without requiring additional individualised permissions.The second source, from the Rio de Janeiro Health Department telemedicine service, contains anonymised, unidentifiable data, whose access was granted upon the researchers'signature of a commitment term for responsible data use. It complies with Brazilian legislation, which waives, in this case, the requirement for the researcher to submit the project to an Institutional Review Board (resolutions 647 of 6/5/2022 and 738 of 1/2/2024 of the National Health Council and the National Research Ethics Committee – CONEP, No. 8000). Consequently, individualised consent to participate is waived and not applicable.

: Not applicable.

: The authors declare no competing interests.