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.

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.