War stress, hypertension, and refugees
This is a story of how war is inscribed in the bodies of female refugees and how science tries to heal these wounds. Fleeing to a safe place is only the first step. For millions of people who have had to leave their homes due to war, physical salvation is the beginning of a long and complicated journey. When the sirens fall silent and the immediate threat to life passes, invisible wounds remain – deep psychological scars that war trauma leaves in minds and souls. However, these wounds are not always exclusively psychological. Increasingly, science is discovering that they can penetrate deeper, inscribing themselves in the body in the form of specific, measurable physical ailments.
This leads us to a fundamental question that has become the heart of a groundbreaking research project at the Medical University of Gdańsk: can extreme stress associated with war and forced migration physically damage the cardiovascular system? Can trauma literally break the heart, leading to the development of life-shortening diseases? The answers to these questions are sought by the WARSCAR project team, led by Dr. Anna Shalimova. Her story is inextricably linked to the research topic – as a Ukrainian scientist from Kharkiv, she is not merely an objective observer, but a person who has personally experienced the drama of war.
The WARSCAR project is more than just a scientific analysis. It is a story of extraordinary Polish-Ukrainian solidarity, human empathy, and the search for healing in the shadow of conflict. Significantly, this study goes beyond passive observation to active intervention and offering treatment to participants diagnosed with arterial hypertension and post-traumatic stress disorder (PTSD).. This methodology fundamentally changes the relationship between researcher and subject, blurring the lines between data collection and providing real medical assistance. The social goal of the project, which is to improve the health and well-being of female refugees, is as important as the scientific goal, making this initiative a humanitarian mission embedded in rigorous scientific frameworks.
To understand the importance of the WARSCAR project, one must first understand arterial hypertension (AH), the leading cause of morbidity and mortality from cardiovascular diseases worldwide. This condition, often called the “silent killer,” may not show any symptoms for years, systematically destroying blood vessels, heart, brain, and kidneys, ultimately leading to heart attacks, strokes, and organ failure.
The main hypothesis of the WARSCAR project assumes a direct link between extreme psychological stress and the development of arterial hypertension. The research team hypothesized that exposure to trauma can raise blood pressure and contribute to the development or worsening of AH and the progression of cardiovascular diseases. The mechanism of this phenomenon is complex and involves interconnected neurohormonal and immunological pathways. The human body is equipped with a “fight or flight” system, which, when faced with danger, releases stress hormones such as adrenaline and cortisol. These raise blood pressure and heart rate, preparing the body for immediate action. This mechanism is extremely effective in the case of short-term dangers. However, war trauma keeps this system in a state of permanent readiness. Chronic stress maintains high levels of hormones that constantly bombard the circulatory system, leading to its gradual damage and the development of hypertension.
Preliminary analysis of the collected data has already yielded an extremely important discovery. Researchers noted that the health of women is affected not only by the primary stress caused by war, but also by an additional, powerful factor – stress related to forced migration. This means that female refugees bear a double burden. The first blow is acute trauma related to violence, fear, and loss of loved ones. The second, chronic blow is the stress resulting from the very fact of being a refugee: loss of home, disruption of social ties, uncertainty about tomorrow, language barriers, and difficulties adapting to a new country.
This distinction is of great importance and can influence health policy towards refugees worldwide. It suggests that support systems must be designed to deal not only with past trauma, but also with current stressors related to the integration process. Interventions focused solely on treating PTSD may prove insufficient if they do not take into account daily challenges such as housing instability or lack of employment. The results of the WARSCAR project can therefore “pave the way for a specific approach to managing cardiovascular risk in people exposed to chronic violence, war, immigrants, and refugees” – as Anna said, not only by identifying the problem, but by breaking it down into its constituent factors.
It is worth emphasizing that the success and very existence of the WARSCAR project are not a matter of chance. It is the culmination of many years of scientific cooperation and a personal relationship built on mutual respect and trust. The history of this cooperation dates back to the end of 2016, when Dr. Anna Shalimova first met Professor Krzysztof Narkiewicz and his team from the Department of Hypertension and Diabetology at the Medical University of Gdańsk. In 2017, she completed a one-year scientific internship under his supervision, during which, as she recalls, she saw “how well-coordinated Professor Narkiewicz’s team is and how comfortably scientific research is conducted in a team of true professionals.” After returning to her hometown of Kharkiv, contacts were not broken, and cooperation continued.
This previously built foundation proved invaluable in the face of the full-scale invasion of Ukraine. Dr. Shalimova emphasizes that the support she received from her Gdańsk colleagues from the first days of the war was extremely important to her. “It is extremely important to me how my Gdańsk colleagues worried about me and supported me so much!” – she says. It was this deep, human bond that made her decide to continue her scientific work.
In the face of the need to leave the country, the choice of location was obvious to her. “I did not consider any other country besides Poland and no other city besides Gdańsk to continue my scientific work,” states Dr. Shalimova in an interview with us. This powerful testimony shows that her decision was dictated not only by professional considerations, but above all by personal trust and the sense of security provided by the presence of trusted friends and scientific partners.
This story shows that the ability to quickly launch a complex and ethically sensitive research project in the midst of a humanitarian crisis was not a matter of luck or funding. It was a direct result of a pre-existing, long-term relationship. This network of trust and communication acted as critical infrastructure that allowed the scientific community to respond quickly and effectively to a global crisis. Long-term international scientific collaborations are therefore not only a tool for developing knowledge in times of peace; they are a form of resilience that allows science to act when it is most needed.
Conducting research in Poland created a unique opportunity to fill a critical knowledge gap. While in Ukraine research on post-traumatic stress focuses mainly on military personnel and people who remained in the country, in Poland there was an opportunity to examine the specific challenges faced by refugees. The WARSCAR project therefore provides data that could not be collected anywhere else, creating a comprehensive picture of the health consequences of war.
Significantly, the WARSCAR project gained recognition in the international scientific community from the very beginning. Its results were presented at the most prestigious forums, including meetings of the European Society of Hypertension, the International Society of Hypertension, and the European Hypertension Forum. Information about the project also appeared in the main bulletin of the International Society of Hypertension, “Hypertension News,” which emphasizes its importance and credibility in the eyes of global experts.
The project led by Dr. Anna Shalimova becomes a bridge connecting different worlds. It translates the subjective experience of trauma into objective physiological data. It creates a bond between the vulnerable community of female refugees and the Polish healthcare system, offering real help. Finally, through actions such as the planned film, it builds a bridge between the academic world and the general public, becoming a voice in defense of the needs and rights of refugees.
