Will people with hypertension and heart disease be mobilized into the AFU in 2026

Hypertension is one of the most common chronic diseases among Ukrainians of conscription age. During martial law, the issue of fitness for service for people with high blood pressure causes a lot of controversy and concern. 

Some citizens are convinced that the mere fact of a diagnosis automatically exempts them from mobilization; however, in practice, the decision depends on the degree of the disease, the presence of complications, and the conclusion of the military medical commission. But Ukrainian legislation provides for different categories of fitness for people with cardiovascular diseases, and the final conclusion is made after a medical examination. 

UNN looked into the topic. 

What degrees of hypertension are considered during mobilization

In which cases high blood pressure can become a basis for restriction or complete exemption from service is currently determined by two documents: Ministry of Defense Order No. 402 and the "Schedule of Diseases" for medics working in military medical commissions (VLC).

According to them, arterial hypertension is divided into several degrees depending on pressure indicators and the presence of target organ damage. During the VLC process, doctors consider not only blood pressure figures but also the person's general condition, the course of the disease, and the effectiveness of treatment.

"With most diseases, to determine fitness for service, it is necessary to understand and analyze the stage, degree, frequency of exacerbations, causes, and consequences of such diseases," explains lawyer Andranik Manasyan. 

The lawyer clarifies that with stage 1 hypertension, a man or woman is recognized as fit for military service.  

"Stage 2 and stage 3 hypertension – (these people – ed.) are fit for support units. This used to be the category of 'limitedly fit'. Stage 3 with complications – unfit. Such people are not mobilized, but are excluded from the military register altogether," the lawyer explained.

According to the documents mentioned above, people with stage II or stage III hypertension without critical organ damage can be mobilized and involved in performing tasks in support units, training centers, logistics, or communications centers. 

How the VLC assesses the condition of people with high blood pressure

When a person undergoes a VLC, doctors evaluate medical documentation, examination results, and treatment history. A single episode of high blood pressure is not enough to establish a serious diagnosis.

"Diagnosing the stage of hypertension is based on the results of multiple measurements (every 2 minutes, at least 2-3 times). Measurements are taken in a sitting position. Normalization of pressure will indicate the absence of hypertension. Therefore, if you are hypertensive and want to prove it to the doctors (VLC commission – ed.) – take your medical documents to the medical examination," Manasyan adds.  

That is why the commission may refer a man or woman for additional examinations. In particular, 24-hour blood pressure monitoring, an electrocardiogram, a heart ultrasound, or a consultation with a cardiologist. In some cases, a decision is made only after an inpatient examination of the person. 

What documents must be provided to the commission to confirm health status 

To confirm the diagnosis, it is important to provide a medical record, hospital discharge summaries, test and examination results, conclusions from specialized doctors, and treatment prescriptions.

Records of ambulance calls due to hypertensive crises, information about hospitalizations, and results of long-term observation are also significant. 

Do complications of hypertension affect the VLC decision

The presence of complications is one of the key factors in assessing fitness. Special attention is paid to the condition of the heart, blood vessels, brain, and kidneys.

If hypertension has led to a heart attack, stroke, heart failure, or serious deterioration of other organs, this may be grounds for being declared unfit for service.

In what cases can a deferment from service be granted

A deferment can be granted to people who are undergoing treatment or require additional examination. Such a decision is made if the state of health temporarily does not allow for the determination of a final fitness category.

After completion of treatment or re-examination, the person is again referred to the VLC for a final decision.

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Can a person be mobilized after a hypertensive crisis

The mere fact of a past crisis does not mean automatic unfitness for service. The frequency of crises, health consequences, and the general course of the disease are important. If serious complications arose after the crisis or if doctors record an unstable condition, this may affect the VLC decision.

What heart and vascular diseases are considered along with hypertension

When assessing health status, concomitant cardiovascular diseases are taken into account. This includes coronary heart disease, heart failure, rhythm disturbances, vascular pathologies, and the consequences of past heart attacks or strokes.

A combination of several diseases can significantly affect the fitness category.

Thus, a man or woman will be recognized as unfit for the defense of the country and excluded from the military register if they are diagnosed with: 

• diseases characterized by high blood pressure 110-115 (hypertensive disease, secondary hypertension);
• stage III hypertensive disease;
• malignant form of hypertensive disease;
• symptomatic arterial hypertension with an increase in blood pressure to degree 3;
• a combination of symptomatic arterial hypertension of any degree with associated clinical conditions;
• condition after pulmonary embolism or pulmonary hypertension due to chronic thrombotic or embolic diseases;
• pulmonary hypertension associated with left heart disease with signs of right ventricular decompensation;
• pulmonary hypertension associated with respiratory system pathology and/or hypoxemia with signs of right ventricular decompensation;
• pulmonary arterial hypertension with severity levels III-IV FC.

Why the diagnosis itself does not guarantee exemption from mobilization

The presence of a "hypertension" diagnosis in itself does not mean automatic exemption from service. The decision is made individually after assessing the degree of the disease, the effectiveness of treatment, and the presence of complications.

That is why people with chronic cardiovascular diseases are advised to undergo regular examinations, keep medical documents, and record the course of treatment. 

"For complete discharge due to hypertension, it is necessary to diagnose not only stage 3 hypertension but also complications in the form of dementia, renal failure, heart failure, hemorrhages, and other similar cardiovascular complications. With such hypertensive disease, they do not take you to war," concludes lawyer Andranik Manasyan.

Recall

The Ministry of Health warns that recently more and more middle-aged people are suffering from cardiovascular ailments. In particular, from hemorrhagic and ischemic strokes. Thus, as of 2019, more than 62% of stroke cases occurred in people under the age of 70.