Screen-detected raised blood pressure and gaps in the hypertension care cascade among adults attending a humanitarian medical mission in Ukraine: A cross-sectional study

Cardiovascular disease is the world's leading cause of death, and raised blood pressure is among its most important modifiable contributors. Conflict tends to interrupt the long-term care that hypertension demands, yet little screening data exist from settings of active conflict. We set out to describe screen-detected raised blood pressure, and the hypertension care cascade, among adults seen at a humanitarian medical mission in Ukraine. In this cross-sectional study we included adults (≥ 18 years) seen consecutively at a MacKay Memorial Hospital mission across three Ukrainian sites in April 2026. Blood pressure was taken once, and we counted a participant as having raised blood pressure if that single reading was ≥ 140/90 mmHg or they reported a previous hypertension diagnosis. Prevalence is reported with Wilson 95% confidence intervals and standardized to the World Health Organization world population; adjusted prevalence ratios come from modified Poisson regression with robust variance. For the cardiovascular screening stream we also described awareness, treatment, and control. Of 364 adults (mean age 52.5 years; 63.2% women), 65.7% of the 341 with complete outcome data had raised blood pressure on the crude estimate (95% confidence interval 60.5-70.5), falling to 54.7% (48.1-61.3) after age standardization. Prevalence climbed with age and was higher in men. Older age (adjusted prevalence ratio 1.19 per 10 years, 1.11-1.27), male sex (1.26, 1.08-1.47), and obesity (1.24, 1.09-1.42) were each independently associated with the outcome. Within the screening stream, 74.6% of those with raised blood pressure were aware, 58.8% were treated, and just 15.8% were controlled; estimates held across multiple imputation and alternative specifications. This was a self-selected sample assessed on a single reading and cannot speak to population prevalence, but the pattern-common raised blood pressure with poor control-makes a reasonable case for building simple screening and a clear referral pathway into missions of this kind.

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Journal
PLoS ONE
Published
2026-09-11
DOI
https://doi.org/10.1371/journal.pone.0357957
Primary Topic
Migration, Health and Trauma
Type
article
Field-Weighted Citation Impact
0.00

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article

Screen-detected raised blood pressure and gaps in the hypertension care cascade among adults attending a humanitarian medical mission in Ukraine: A cross-sectional study

Kun‐Zhe Tsai, Weide Tsai, Kuan‐Ting Chen, En-Tse Yen et al.
PLoS ONE
Migration, Health and Trauma
article

Screen-detected raised blood pressure and gaps in the hypertension care cascade among adults attending a humanitarian medical mission in Ukraine: A cross-sectional study

Kun‐Zhe Tsai, Weide Tsai, Kuan‐Ting Chen, En-Tse Yen, Regina Maistrova, Shih-Ying Lin
article en

Abstract

Cardiovascular disease is the world's leading cause of death, and raised blood pressure is among its most important modifiable contributors. Conflict tends to interrupt the long-term care that hypertension demands, yet little screening data exist from settings of active conflict. We set out to describe screen-detected raised blood pressure, and the hypertension care cascade, among adults seen at a humanitarian medical mission in Ukraine. In this cross-sectional study we included adults (≥ 18 years) seen consecutively at a MacKay Memorial Hospital mission across three Ukrainian sites in April 2026. Blood pressure was taken once, and we counted a participant as having raised blood pressure if that single reading was ≥ 140/90 mmHg or they reported a previous hypertension diagnosis. Prevalence is reported with Wilson 95% confidence intervals and standardized to the World Health Organization world population; adjusted prevalence ratios come from modified Poisson regression with robust variance. For the cardiovascular screening stream we also described awareness, treatment, and control. Of 364 adults (mean age 52.5 years; 63.2% women), 65.7% of the 341 with complete outcome data had raised blood pressure on the crude estimate (95% confidence interval 60.5-70.5), falling to 54.7% (48.1-61.3) after age standardization. Prevalence climbed with age and was higher in men. Older age (adjusted prevalence ratio 1.19 per 10 years, 1.11-1.27), male sex (1.26, 1.08-1.47), and obesity (1.24, 1.09-1.42) were each independently associated with the outcome. Within the screening stream, 74.6% of those with raised blood pressure were aware, 58.8% were treated, and just 15.8% were controlled; estimates held across multiple imputation and alternative specifications. This was a self-selected sample assessed on a single reading and cannot speak to population prevalence, but the pattern-common raised blood pressure with poor control-makes a reasonable case for building simple screening and a clear referral pathway into missions of this kind.

PLoS ONEVol. 21(9)
National Taiwan University (TW), Mackay Memorial Hospital (TW), Mackay Medical University (TW), Young Men's Christian Association (US), National Defense Medical Center (TW), Matsumoto Dental University (JP)
Mackay Memorial Hospital
Openalex Percentile: Top 7%
Migration, Health and Trauma
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