The "pressure" of being an adolescent in the West Bank, Palestine: prevalence of prehypertension and hypertension.

INTRODUCTION

Over 27% of adults in Palestine are reported to have hypertension, and there is limited knowledge about hypertension rates among Palestinian adolescents residing in the West Bank, Palestine. Prolonged exposure to forced displacement has adverse impacts on health, including the risk of hypertension. This study assessed the relationship between refugee status, prehypertension, and hypertension among Palestinian adolescents residing in the West Bank, Palestine.

METHODS

This cross-sectional study was conducted among Palestinian adolescents residing in refugee camps, villages, and cities across the West Bank. A random sample of adolescents was recruited from schools from November 2022 to January 2023. Anthropometric measurements, including blood pressure (mmHg), heart rate (BPM), body fat (%), height (cm), and body weight (kg), and survey questionnaires, were collected. Ordinal regression models were used to assess the relationship between refugee status, prehypertension, and hypertension after adjusting for age. In addition, the interaction between refugee status and sex and its relationship to the prevalence of prehypertension and hypertension were examined.

RESULTS

A total of 706 Palestinian adolescents [refugees = 377 (39.4% female individuals and 60.6% male individuals), and non-refugees = 329 (39.9% female individuals and 60.1% male individuals)] aged between 13 and 17 years (median = 14 years) were enrolled. The prevalence of prehypertension and hypertension in the sample was 26 and 14%, respectively. The prevalence of prehypertension [refugees = 25.5% vs. non-refugees = 27.0%] and hypertension [refugees = 12.7% vs. non-refugees = 16.0%] was higher among non-refugees. There was no association between refugee status and hypertension categories in either the unadjusted models or models adjusted for age [adjusted odds ratio (AOR) 0.88; 95% CI = 0.65-1.20]. The findings from the regression models revealed an association between refugee status, prehypertension, and hypertension among female and male participants. Among female participants, refugees had 1.75 [95%CI = 1.04-2.95] times higher odds of elevated blood pressure than non-refugees, after adjusting for age. In contrast, male refugees had 40% lower odds [AOR = 0.6; 95% CI = 0.41-0.88] of elevated blood pressure than their non-refugee counterparts.

CONCLUSION

The prevalence of prehypertension and hypertension was high in this participant sample, highlighting a significant public health concern. Inverse relationships between blood pressure and refugee status were observed across sexes. Future studies should assess the impact of refugee and non-refugee experiences and sex differences on cardiovascular health disparities among Palestinian adolescents.