Cardiovascular disease risk and associated factors among people with hypertension in the West Bank, Palestine

Background Hypertension is a major contributor to cardiovascular disease (CVD) morbidity and mortality worldwide, particularly in low- and middle-income countries where comprehensive risk-based prevention remains limited. Estimation of absolute cardiovascular risk offers a more informative approach to prevention than blood pressure control alone. However, evidence on predicted cardiovascular risk and its determinants among People with hypertension in Palestine remains scarce. Methods An institution-based cross-sectional study was conducted between August and October 2025 among People with hypertension attending selected healthcare facilities in the West Bank, Palestine. Data were collected using structured interviewer-administered questionnaires, clinical assessments, and laboratory records. Predicted 10-year cardiovascular disease risk was estimated using the World Health Organization (WHO) laboratory-based cardiovascular risk prediction charts. Descriptive statistics summarized participant characteristics, and multivariable logistic regression analyses were performed to identify independent determinants of elevated cardiovascular risk. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p < 0.05. Results A total of 401 People with hypertension were included (mean age 59.2 ± 11.3 years), of whom 63.1% were female. Among 401 participants with hypertension, 50.4% were classified as having moderate-to-high predicted 10-year cardiovascular disease risk, including 24.7% classified as high risk. Increasing age was the most consistent determinant of cardiovascular risk, with each additional year associated with higher odds of CVD (aOR ≈ 1.04, p < 0.001). Diabetes mellitus was independently associated with high predicted cardiovascular risk and established CVD (aOR range ≈ 1.8–2.4, p ≤ 0.01). A positive family history of hypertension remained independently associated with cardiovascular disease (aOR ≈ 1.9, p < 0.01), while marital status demonstrated a protective association (aOR ≈ 0.5, p < 0.01). Lifestyle-related factors, including obesity, smoking, and physical inactivity, were highly prevalent but did not retain independent associations after multivariable adjustment. Conclusions People with hypertension in the West Bank carry a substantial burden of predicted cardiovascular disease risk, driven primarily by advancing age, diabetes mellitus, and familial susceptibility. Integrating routine cardiovascular risk assessment and comprehensive cardiometabolic management into hypertension care may improve targeted prevention strategies and reduce the burden of cardiovascular disease in Palestine.