Cardiovascular risk factors and the challenge of chronic disease management in conflict-affected Ukraine: a cross-sectional pilot study from a humanitarian mission

Background Ukraine faced a significant burden of non-communicable diseases (NCDs) prior to the 2022 full-scale invasion, with age-standardized cardiovascular disease disability-adjusted life years (DALYs) estimated at 2.6 times the European average. Armed conflict exacerbates chronic conditions by disrupting healthcare systems and increasing physiological and psychological stress. However, primary clinical data from civilians in conflict-affected regions of Ukraine remain scarce. This study aimed to characterize the prevalence of cardiovascular risk factors and identify predictors of poor health outcomes among conflict-affected civilians. Methods A cross-sectional study was conducted among 239 civilians presenting to mobile medical clinics during a humanitarian mission in Ukraine from September 17–27, 2025. Data were collected on demographics, anthropometrics, blood pressure, and behavioral factors. Validated screening tools assessed mental health (Brief Symptom Rating Scale-5), appetite (Simplified Nutritional Appetite Questionnaire), and malnutrition risk (Malnutrition Screening Tool). Multivariable logistic regression identified predictors of hypertension, obesity, and mental health risk. Results The study population was predominantly female (66.5%) with a mean age of 51.4 years. Cardiovascular risk factors were present at alarmingly high rates. The combined prevalence of Stage 1 and Stage 2 hypertension was 83.7%, with 40.2% (95% CI: 34.1%–46.5%) having Stage 2 hypertension (≥ 140/90 mmHg). The prevalence of overweight or obesity (≥ 25 kg/m²) was 67.4% (95% CI: 61.1%–73.0%), with 32.6% meeting criteria for obesity (≥ 30 kg/m²). In adjusted models, older age (OR 1.06; 95% CI: 1.04–1.08) and obesity (OR 3.91; 95% CI: 2.08–7.34) were significant predictors of hypertension. A syndemic relationship was identified where obesity (OR 2.20; 95% CI: 1.12–4.32) and malnutrition risk (OR 3.56; 95% CI: 1.58–7.98) were significant predictors of mental health risk. Conclusions The findings reveal a severe and uncontrolled burden of cardiovascular risk factors among civilians in conflict-affected Ukraine, far exceeding pre-conflict national baselines. The observed syndemic of physical and mental health conditions necessitates an urgent shift in the humanitarian response towards integrated care models that address NCDs and mental health concurrently.