Stress-Related Autonomic Imbalance and Early Blood Pressure Changes in Apparently Healthy Adults Living Under Wartime Conditions

Objective: In wartime conditions, even populations living in non-combat regions are exposed to prolonged psychosocial stress related to forced migration, social uncertainty, and continuous informational pressure, which may contribute to chronic stress. Related emotional reactions may be linked to sympathetic overactivation and early blood pressure changes, complicating timely diagnosis of previously undetected arterial hypertension in individuals who consider themselves practically healthy. Design and method: This pilot study included 36 apparently healthy adults aged 28–46 years (mean age 38.3 ± 8.9 years); 47.72% were men and 52.78% women. Participants were divided into groups: Group 1 (n = 15): individuals living abroad for at least 10 years (mean duration 11.8 ± 1.3 years); Group 2 (n = 21): internally displaced persons from temporarily occupied territories of Ukraine. All participants underwent clinical examination, office blood pressure measurement, 24-hour ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV) assessment using standard time- and frequency-domain analysis to evaluate autonomic nervous system regulation. Although participants had no formal cardiovascular complaints or previously diagnosed hypertension at baseline, detailed medical interviews revealed occasional non-specific symptoms (episodic palpitations, headaches, or fatigue), which motivated their participation in general cardiovascular screening. Results: According to ABPM data, mean 24-hour systolic blood pressure was significantly higher in Group 2 compared with Group 1 (+10.44%, p < 0.05), while diastolic blood pressure did not differ significantly between groups. HRV analysis revealed a predominance of sympathetic autonomic modulation, indicating autonomic imbalance in Group 2, with statistically significant differences compared to Group 1 (p < 0.001). During further clinical evaluation, arterial hypertension was diagnosed in 5 individuals from Group 2 and in one individual from Group 1. Among group 2 participants, two reported symptoms of increased anxiety, three had a family history of hypertension, and two were overweight. Conclusions: Chronic stress associated with wartime circumstances was associated with autonomic dysregulation, reflected by altered heart rate variability, and higher systolic blood pressure even in young individuals who consider themselves healthy. Careful medical surveillance and preventive screening of stress-exposed vulnerable population groups may facilitate early detection of arterial hypertension and improve cardiovascular risk stratification.tings.