ARTERIAL HYPERTENSION AND STRESS DISORDERS: A COMPARATIVE ASSESSMENT IN UKRAINIAN REFUGEE WOMEN AND WOMEN REMAINING IN UKRAINE DURING THE WAR

Objective: Since February 2022, Ukrainians have been under constant war-induced stress. Many Ukrainians, primarily women and children, were forced to leave the country to escape the war. The aim of this study was to compare the severity of hypertension and stress disorders among Ukrainian women seeking asylum in Poland and those remaining in Ukraine during the war. Design and method: The current analysis included 173 Ukrainian refugee women living in Poland and 161 women remaining in Ukraine (Kharkiv, Kyiv, Ivano-Frankivsk) evaluated one year after the start of the war in Ukraine. Participants completed validated questionnaires for depression, stress, and anxiety (DASS-21) and PTSD (PCL-5). Office blood pressure (BP) was measured according to ESH guidelines. Results: Women remaining in Ukraine were significantly older than refugees (50.5±14.5 vs. 45.3±13.3 years, P<0.001). The prevalence of hypertension was significantly higher among women remaining in Ukraine (67.7% vs. 36.7%, P< 0.0001). However, BP control was notably worse in the refugee group (5.2% vs. 38.5% in women remaining in Ukraine, P<0.0001). Despite a higher percentage of refugees reporting feeling completely safe compared to women staying in Ukraine (37% vs 9.9%, p<0.0001), the DASS-21 score (24.7±14.7 vs 17.9±10.1, p<0.0001), including all its components (depression, anxiety, and stress), was significantly higher among refugees. Furthermore, PTSD global score (28.2±14.4 vs 20.2±10.2, p<0.0001) and scores for re-experiencing trauma, hyperarousal and cognitive and mood alterations were significantly higher in refugees. Notably, 74% of refugees identified the war as the most significant stress factor in their lives compared to 48% of women staying in Ukraine (P<0.0001). Conclusions: Our data indicate more severe depression, anxiety and PTSD among refugees in Poland compared to women remaining in Ukraine. This may be attributed to additional challenges associated with forced migration, such as limited access to medical care, to employment, social isolation and language barriers. Alternatively, refugees may carry with them a higher burden of previous exposure to violence, requiring targeted medical and mental health follow-up.