Abstract MP69: The “Pressure” of Being an Adolescent in Palestine: Prehypertension and Hypertension Prevalence

Abstract

Introduction: Prolonged exposure to geo-political violence and forced displacement has adverse health impacts, such as hypertension in Palestinian populations residing in Palestine. Over 27% of adults in Palestine are reported as hypertensive, yet there is limited knowledge of hypertension rates among Palestinian adolescents. This study assessed the relationship between refugee status and (pre)hypertension among Palestinian adolescents residing in Palestine. Hypothesis: We hypothesized refugees would demonstrate higher prehypertension (PHTN;121/<80 to 129/<80 mmHg) and hypertension (HTN; ≥130/ ≥ 80 mmHg) prevalence compared to non-refugees, after controlling for age and sex. Methods: This cross-sectional study was conducted among Palestinian adolescents residing in refugee camps, villages, and cities in Palestine. A random sample of adolescents was recruited through schools from November 2022 to January 2023. Anthropometric measurements including blood pressure (mmHg), heart rate (BPM), body fat (%), height (cm), body weight (kg) and survey questionnaires were collected. Ordinal regression models were used to assess the relationship between refugee status and (pre)hypertension while controlling for age and sex. Interaction effects were conducted to assess the relationship of refugee status by sex on (pre)hypertension. Results: A total of 706 Palestinian adolescents (refugees= 377, [39.4 % females, 60.6 % males] and non-refugees= 329 [39.9% females, 60.1% males]) aged 13-17 (median= 14 years) participated. The overall prevalence of PHTN and HTN was 52.5% and 28.7%, respectively. Refugees had a lower prevalence of PHTN [25.5% vs. 27.0%] and HTN [12.7% vs. 16.0%] compared to non-refugees, although confidence intervals overlapped. Overall, there was no association between refugee status and (pre)hypertension in unadjusted models, or models adjusting for age and sex [AOR 0.88; 95% CI= 0.65-1.20]. The distribution of percent body fat was higher for non-refugees [37%; 95% CI=21%-39%] compared to refugee groups [24%; 95% CI=18-31]. Interaction effect regression models showed an association between refugee status and (pre)hypertension among females. Among females, refugees had 1.75 [95%CI=1.04-2.95] times higher odds of (pre)hypertension than non-refugees after adjusting for age. Conclusions: The overall PHTN and HTN prevalence for this participant sample is four and seven times the global average, denoting an alarming public health burden. Future studies should consider the assessment of psychosocial factors that may drive cardiovascular health disparities in adolescent Palestinians.