Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon

BackgroundHypertension significantly contributes to global morbidity and mortality rates. Refugees are often exposed to significant risk factors that increase their chances of developing hypertension; however, the prevalence of hypertension among resettled refugees remains understudied. This study e...

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Main Authors: Tala Al-Rousan, Wadih Naja, Christian Morberg Wejse, Dahlia Kaki, Michaelangelo Aoun, Saskia Lange, Laith Alshawabkeh, Rima Alhamad, Nadine Kadri, Andreas Halgreen Eiset
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1486806/full
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author Tala Al-Rousan
Wadih Naja
Wadih Naja
Wadih Naja
Christian Morberg Wejse
Dahlia Kaki
Michaelangelo Aoun
Michaelangelo Aoun
Michaelangelo Aoun
Saskia Lange
Laith Alshawabkeh
Rima Alhamad
Nadine Kadri
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
author_facet Tala Al-Rousan
Wadih Naja
Wadih Naja
Wadih Naja
Christian Morberg Wejse
Dahlia Kaki
Michaelangelo Aoun
Michaelangelo Aoun
Michaelangelo Aoun
Saskia Lange
Laith Alshawabkeh
Rima Alhamad
Nadine Kadri
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
author_sort Tala Al-Rousan
collection DOAJ
description BackgroundHypertension significantly contributes to global morbidity and mortality rates. Refugees are often exposed to significant risk factors that increase their chances of developing hypertension; however, the prevalence of hypertension among resettled refugees remains understudied. This study estimates and compares the prevalence of hypertension, levels of awareness, and access to care between two groups of Syrian refugees residing in humanitarian settings in Lebanon and Denmark.MethodsWe analyzed cross-sectional data collected from refugee camps in Lebanon and asylum centers in Denmark. Cluster-randomized sampling was conducted between January 2016 and December 2019. We present the estimates of hypertension prevalence, psychosocial stress, and lifestyle factors by strata, along with prevalence differences adjusted for confounding using propensity score weighting. Multiple imputation was employed to address missing data, and 95% bootstrap confidence intervals were reported.ResultsOf the 712 participants, 113 were from Denmark and 599 from Lebanon. Among them, 68% were women, and the median (IQR) age was 34 years (19). The self-reported prevalence of hypertension was 20% in Lebanon and 11% in Denmark. The prevalence of measured stage 2 hypertension was 23% in Lebanon and 24% in Denmark. The confounder-adjusted and multiple-imputed prevalence of hypertension was 5.0 (95% CI: −4.7; 16.1) percentage points higher in Denmark than in Lebanon. Among those with a known diagnosis of hypertension, only 1.6% in Lebanon and none in Denmark were currently taking medications for hypertension. The median (IQR) number of days since last seen by a medical professional was 8 days (48) in Lebanon and 8 days (21) in Denmark. The mean body mass index (BMI) was 27.0 (SD = 6.15) in Lebanon and 26.2 in Denmark (SD = 6.53). In Denmark, 50.5% reported smoking, and 23.6% reported drinking alcohol, while in Lebanon, the figures were 27.4 and 0.5%, respectively.ConclusionHypertension prevalence was found to be high among refugees, even in high-income countries (HICs) such as Denmark. Lack of access to medications in relation to self-reported prevalence was observed in both Lebanon and Denmark. Further investigation into psychosocial stress in humanitarian settings as a contributing factor to hypertension disparities in this population is crucial.
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spelling doaj-art-027a973405d44e7ba5fc9c2f7d69bfe22025-08-20T02:10:05ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.14868061486806Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and LebanonTala Al-Rousan0Wadih Naja1Wadih Naja2Wadih Naja3Christian Morberg Wejse4Dahlia Kaki5Michaelangelo Aoun6Michaelangelo Aoun7Michaelangelo Aoun8Saskia Lange9Laith Alshawabkeh10Rima Alhamad11Nadine Kadri12Andreas Halgreen Eiset13Andreas Halgreen Eiset14Andreas Halgreen Eiset15Andreas Halgreen Eiset16Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United StatesDepartment of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand, Beirut, LebanonDepartment of Psychiatry and Clinical Psychology, Mont Lebanon Hospital - University Medical Center, Hazmieh, LebanonDepartment of Psychiatry, Lebanese University, Beirut, LebanonGloHAU, Center for Global Health, Department of Public Health, Aarhus University, Aarhus, DenmarkUniversity of California, San Francisco, San Francisco, CA, United StatesDepartment of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand, Beirut, LebanonDepartment of Psychiatry and Clinical Psychology, Mont Lebanon Hospital - University Medical Center, Hazmieh, LebanonDepartment of Biomedicine, Aarhus University, Aarhus, DenmarkCharité - University Medicine Berlin, Berlin, GermanyDivision of Cardiology, Department of Medicine, University of California, San Diego, San Diego, CA, United States0University of Waterloo, Waterloo, ON, Canada1Western University of Health Sciences, Pomona, CA, United StatesGloHAU, Center for Global Health, Department of Public Health, Aarhus University, Aarhus, DenmarkDepartment of Biomedicine, Aarhus University, Aarhus, Denmark2Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark3Department of Anesthesiology, Regional Hospital Horsens, Horsens, DenmarkBackgroundHypertension significantly contributes to global morbidity and mortality rates. Refugees are often exposed to significant risk factors that increase their chances of developing hypertension; however, the prevalence of hypertension among resettled refugees remains understudied. This study estimates and compares the prevalence of hypertension, levels of awareness, and access to care between two groups of Syrian refugees residing in humanitarian settings in Lebanon and Denmark.MethodsWe analyzed cross-sectional data collected from refugee camps in Lebanon and asylum centers in Denmark. Cluster-randomized sampling was conducted between January 2016 and December 2019. We present the estimates of hypertension prevalence, psychosocial stress, and lifestyle factors by strata, along with prevalence differences adjusted for confounding using propensity score weighting. Multiple imputation was employed to address missing data, and 95% bootstrap confidence intervals were reported.ResultsOf the 712 participants, 113 were from Denmark and 599 from Lebanon. Among them, 68% were women, and the median (IQR) age was 34 years (19). The self-reported prevalence of hypertension was 20% in Lebanon and 11% in Denmark. The prevalence of measured stage 2 hypertension was 23% in Lebanon and 24% in Denmark. The confounder-adjusted and multiple-imputed prevalence of hypertension was 5.0 (95% CI: −4.7; 16.1) percentage points higher in Denmark than in Lebanon. Among those with a known diagnosis of hypertension, only 1.6% in Lebanon and none in Denmark were currently taking medications for hypertension. The median (IQR) number of days since last seen by a medical professional was 8 days (48) in Lebanon and 8 days (21) in Denmark. The mean body mass index (BMI) was 27.0 (SD = 6.15) in Lebanon and 26.2 in Denmark (SD = 6.53). In Denmark, 50.5% reported smoking, and 23.6% reported drinking alcohol, while in Lebanon, the figures were 27.4 and 0.5%, respectively.ConclusionHypertension prevalence was found to be high among refugees, even in high-income countries (HICs) such as Denmark. Lack of access to medications in relation to self-reported prevalence was observed in both Lebanon and Denmark. Further investigation into psychosocial stress in humanitarian settings as a contributing factor to hypertension disparities in this population is crucial.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1486806/fullhypertensionrefugeeshealthcare accessprevalenceglobal health
spellingShingle Tala Al-Rousan
Wadih Naja
Wadih Naja
Wadih Naja
Christian Morberg Wejse
Dahlia Kaki
Michaelangelo Aoun
Michaelangelo Aoun
Michaelangelo Aoun
Saskia Lange
Laith Alshawabkeh
Rima Alhamad
Nadine Kadri
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Andreas Halgreen Eiset
Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
Frontiers in Public Health
hypertension
refugees
healthcare access
prevalence
global health
title Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
title_full Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
title_fullStr Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
title_full_unstemmed Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
title_short Hypertension in Syrian refugees: prevalence, awareness, and access to care in Denmark and Lebanon
title_sort hypertension in syrian refugees prevalence awareness and access to care in denmark and lebanon
topic hypertension
refugees
healthcare access
prevalence
global health
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1486806/full
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