ASSOCIATION OF HIGH BLOOD PRESSURE WITH POST-TRAUMATIC STRESS DISORDER IN UKRAINIAN WOMEN SEEKING ASYLUM IN POLAND: A PILOT STUDY

Abstract

Objective: Post-traumatic stress disorder (PTSD) and its components have been associated with hypertension, particularly in military servants, war veterans and more recently in populations exposed to chronic violence. However, to our knowledge, this association has not been investigated in refugees. The objective of this study was to explore the potential association between high blood pressure and PTSD in Ukrainian women seeking asylum in Poland. Design and method: From September to December 2022, 55 Ukrainian women refugees were enrolled in dormitories from Sopot (Poland). Blood pressure (BP) was measured using validated oscillometric devices. Hypertension was defined as systolic BP > = 140 mmHg, diastolic BP > = 90 mmHg or being on antihypertensive treatment. Relevant demographic and clinical data were obtained. Furthermore, subjects filled validated questionnaires for depression, stress and anxiety (DASS) and post-traumatic stress disorder (PTSD) (PCL-5). Subjects with and without hypertension were compared for both general and psychological characteristics. Results: Thirty out of 55 subjects were found to be hypertensive. Compared to subjects with normal BP in absence of drugs (mean BP: 117.8/75.6 mmHg, n = 25), hypertensive subjects (mean BP: 138.1/85.8 mmHg, n = 30) were older (57.2 ± 11.1 vs. 39.1 ± 0.8 years, p < 0.00001) and had a higher BMI (29.0 ± 5.4 vs. 23.8 ± 4.4 kg/m2, p = 0.003). Furthermore, despite a similar personal situation (socio-economic background, direct exposure to war, time since arrival in Poland, with or without children/relatives), hypertensive subjects were more often feeling unsafe at the time of examination (4-items scale, p = 0.001) and scored higher for PTSD score (24.9 ± 17.0 vs. 16.3 ± 12.9, p = 0.038), particularly regarding intrusion (cluster B, p = 0.039) and hyper-arousal (cluster E, p = 0.002) dimensions, but not for DASS score (22.4 ± 14.2 vs. 17.2 ± 11.5, p = 0.14). Conclusions: This preliminary analysis is consistent with an association between high BP and both feeling of being unsafe and PTSD score in Ukrainian women refugees. Our results need confirmation using 24-hour BP monitoring and in a larger sample. In the absence of difference in personal background and exposure to war, these associations may reflect underlying differences in expression of emotions and coping abilities, as previously shown in other populations exposed to violence or with difficult-to-treat hypertension.