ANXIETY IS AN INDEPENDENT PREDICTOR OF HYPERTENSION IN UKRAINIAN WOMEN REFUGEES IN POLAND

Objective: An association between anxiety and hypertension has been described both in cross-sectional and prospective studies. However, the contribution of anxiety to the risk of hypertension in patients exposed to war, chronic violence and particularly refugees has not received much attention so far. Design and method: 548 Ukrainian women refugees were enrolled from September 2022 to June 2024 from Sopot Center for Integration and Support for Foreigners, Tricity area (Gdansk, Sopot, Gdynia, Poland). Office blood pressure was measured according to ESH recommendations using a validate oscillometric blood pressure device (Microlife WatchBP office ABI). Hypertension was defined as systolic blood pressure >= 140mmHg, diastolic blood pressure >= 90mmHg and/or intake of antihypertensive treatment. Participants completed a self-report scale designed to measure depression, anxiety and stress (DASS-21). Subjects with and without hypertension were compared for both general and psychological characteristics. Results: 234 out of 548 participants (42%) were found to be hypertensive. Compared to normotensive subjects, participants with hypertension were older (55.6 ±11.6 vs. 38.9 ±9.9 years, p<0.001) and had a higher body mass index (BMI) (29.0 ±4.6 years vs. 24.7 ±4.3 kg/m2, p<0.001). Hypertensive subjects scored higher in the dimensions of depression (7.9±5.1 vs. 6.9±5.2, p=0.026) and anxiety (8.4±5.4 vs. 6.3±5.2, p<0.001) but not for stress (11.1±5.2 vs. 10.4±5.2, p=0.14). Furthermore, the proportion of patients with severe anxiety was significantly higher in hypertensive compared to normotensive women (49.3% vs. 36.1%, p<0.001). The level of anxiety but not depression or stress remained independently associated (p=0.011) with hypertension in a multivariable model (p<0.001) also including age and BMI. Conclusions: Anxiety, but not stress and depression, appears as a strong, independent predictor of hypertension in Ukrainian women refugees. Adequate management of anxiety in this population exposed to war may help to prevent and control hypertension, and subsequent cardiovascular complications.