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Background. During prolonged military operations, chronic stress, constant threat to life, losses, limited access to medical care — all contribute to the exacerbation and progression of cardiovascular diseases. Military operations in Ukraine have led to a significant increase in the frequency of arterial hypertension (AH), myocardial infarction and stroke among the military and civilian population. The purpose was to determine the features of clinical manifestations of AH in patients with high blood pressure (BP) at the primary care level in Ukraine during the full-scale military conflict and the features of prescribing therapy taking into account the main modern international guidelines. Materials and methods. The study included 1200 adults (18 to 80 years old) with established stage 1–2 AH (BP < 160/110 mm Hg). Communication with patients, history taking, physical, instrumental and laboratory examination, prescription (escalation) of therapy were performed by primary care physicians (family doctors). All patients underwent three stages: 1) inclusion visit — assessment of history, BP, heart rate, biochemical analysis results, orthostatic test, prescription of antihypertensive therapy; 2) titration visit — assessment of BP, heart rate, adherence to therapy (Morisky questionnaire), side effects, biochemical analysis results; 3) completion visit — assessment of BP, heart rate, side effects, biochemical analysis results, orthostatic test, choice of further therapy. At the inclusion visit, doctors, at their discretion, prescribed patients with mild uncomplicated hypertension a free combination based on the generic drug ramipril with amlodipine or hydrochlorothiazide. Results. Results of 1183 participants (men/women — 49.3/50.7 %) aged 57.4 ± 0.4 years, body mass index — 28.9 ± 0.2 kg/m2, cholesterol — 5.90 ± 0.04 mmol/l, estimated glomerular filtration rate — 83.5 ± 0.3 ml/min/1.73 m2 were available for analysis. Diabetes — 18.9 %, 2.7 % had a positive orthostatic test, office systolic/diastolic BP — 158.0 ± 0.4/92.8 ± 0.3 mm Hg. The frequency of severe AH complications before the start of the study was low: acute coronary syndrome/myocardial infarction more than 12 months ago — 8.9 %, transient ischemic attack/stroke — 7.9 %, current chronic heart failure of functional class II — 24.5 %, chronic kidney disease stage 2–3a — 2.3 %. The frequency of identification of untreated patients with AH in the primary care settings was 37 %. Among the treated patients, 41 % received monotherapy, 59 % — combination therapy (39 % — free combinations, 61 % — fixed combinations in one tablet, often captopril with hydrochlorothiazide). Before inclusion in the study at the family doctor stage, all patients treated were prescribed drugs that block renin-angiotensin system: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (96/17 %), 36 % — thiazides, and 30 % — beta-blockers. Subsequently, against the background of combination therapy and thanks to the proposed escalation scheme for prescribing drugs, the vast majority of included patients achieved BP control with a decrease in the average blood pressure level by 29/14 mm Hg and a decrease in the office systolic BP to 129 and diastolic BP — to 79 mm Hg, which corresponds to the target blood pressure level in the 2024 and 2025 guidelines. Conclusions. In Ukraine, initial therapy more often begins with monotherapy, rather than with combination therapy, as in Europe. Due to interruptions in the supply of original drugs in the context of military conflict, doctors switch to more affordable generics and simplify treatment regimens. Rapid- and short-acting drugs, as well as combination agents based on them, are often used. The frequency of prescribing calcium channel blockers was low (26 %), angiotensin II receptor blockers — only 17 %. A significant proportion of patients (more than 30 %) in the primary care settings were not covered by antihypertensive therapy, despite the already established diagnosis of AH.