Magnitude and Factors Associated with Hypertension among Conflict-affected Adults in Northern Ethiopia: A Community-Based Cross-Sectional Study

Abstract Background: Hypertension is a growing public health problem worldwide; however, evidence of the burden and determinants in populations affected by conflict and displacement remains limited. This study aimed to determine the magnitude of hypertension and associated factors among conflict-affected adults. Methods: We conducted a community based, cross-sectional study in September and October 2025, among 839 adults aged 25-65 years who were internally displaced, returnees or conflict survivors. Socio-demographics, wealth status, behavioral characteristics, mental health and conflict related experiences data were collected using interview-administered questionnaires following standardized blood pressure and anthropometric measurements. Modified Poisson regression with robust variance was used to estimated crude and adjusted prevalence ratios. Factors with p < 0.05 were considered statistically significant. Results: Overall, 839 were enrolled, 467 (55.7%) were female, the median age was 41 (IQR: 35-46) years, and 264 (31.5%) had hypertension. Factors associated with hypertension were age >44 years, bereavement (aPR=1.89, 95%CI: 1.60-2.25) experiencing major property loss (aPR=1.34, 95%CI: 1.01-1.77), psychological stress (aPR=1.99, 95%CI: 1.57-2.52), lower physical activity (aPR=2.02, 95CI: 1.24-3.30) and processed food consumption (aPR=1.36, 95%CI: 1.17-1.59). Conclusion: The burden of hypertension among conflict-affected populations in Ethiopia is high. Hypertension was significantly associated with several socio-demographic, behavioral, psychosocial, and biological factors. These findings highlight the need for integrated, context-specific interventions that combine cardiovascular care with mental health support, social protection, and strengthened primary health systems in conflict-affected settings. Keywords: Conflict-affected, Hypertension, Crisis-driven, Bereavement and Bio-psychosocial.