PROLONGED EXPOSURE TO COMBAT-RELATED STRESS AND ARTERIAL HYPERTENSION IN CROATIAN MILITARY VETERANS

Objective: Military veterans are at increased risk for cardiovascular (CV) diseases, including arterial hypertension (AH), due to prolonged exposure to combat-related stress and lifestyle factors. This study examines the relationship between AH and the duration of active duty service in Croatian military veterans. Design and method: A prospective analysis was conducted on a cohort of Croatian military veterans undergoing annual health examinations. Participants were divided into two groups based on their active duty duration: <500 days and >500 days. Data collection included structured questionnaires, laboratory tests, and blood pressure measurements using the Omron M6 device. Central blood pressure was determined by Mobil-O-Graph device. In this analysis statistical tests used were independent T-test (students t-test) for mean differences on continous variables and Chi-sqare test of independence for categorical and nominal data between two groups (<500 & >500 days groups of subjects). Numerical variables with a normal distribution were presented with a mean and standard deviation, m±SD. All statistical differences were tested on significance level of 5%. Results: The study included veterans with a mean age of 54.63±7.08 years (93.0% male). Key findings include: 65.0% of participants had arterial hypertension, with a significantly higher prevalence in those with >500 days of active duty (p=0.001). Veterans with longer service durations had higher BMI (p=0.000), higher pulse wave velocity (PWV) (p=0.015), and a greater incidence of diabetes. Use of antihypertensive medication was more common among veterans with >500 days of service (p=0.006), yet 40.0% of them had uncontrolled but treated hypertension (p=0.000). Longer active duty duration was associated with higher central aortic pressure (CAP) (p=0.001) and an increased 10-year CV risk score (p=0.001). Conclusions: Veterans who served more than 500 days in active combat exhibited higher CV risk, increased arterial hypertension prevalence, and poorer blood pressure control. These findings highlight the need for targeted cardiovascular screening and management programs for military veterans. Further research is required to differentiate the impact of war-related stress from lifestyle factors in the long-term health outcomes of this population.