Data from World Health Organization (2002), estimated that high blood pressure was the cause of death for more than 7 million individuals every year, affecting 972 million of world population which accounts for 26. 4% in total, 26. 6% of those are men and 26. 1% are women. In addition 333 million of those in developed countries and 639 million in developing countries and responsible for 11% of all diseases burden in industrial countries, it also estimated to be the case of death for more than 20% in men and almost 24% in women (World Health Organization, 2003), (Kearney et al, 2005).
In the future, high blood pressure is predicted to increase about 60% by 2025 to reach a total of 1. 56 billion. This increase expected to contribute of 9% and 13% in both men and women respectively (Kearney et al, 2005). Globally, the highest prevalence rate of high blood pressure found in women in former socialist economies region while for men was in Latin American and Caribbean region and the lowest prevalence was in “other Asian and islands” region for both men and women. (Kearney et al, 2005).
High blood pressure considered one of the main risk factor of cardiovascular diseases, which contributes with 62% of cardiovascular diseases globally. It also contributes to 54% of stroke cases and 47% ischemic heart disease (Lawest et al, 2008). Moreover it is responsible for 50% of heart failure burden in the world (Lloyd et al, 2002). The interheart study estimated that having a hypertension was the reason for 25% of heart attack cases in both central and Eastern Europe while it represents the same reason for 22 % of Western Europe.
Individuals who have an elevated blood pressure are suspect to have heart attack twice more than normotensive (Yusuf et al, 2004) or British heart static cite both of them In terms of disability –adjusted life-years, high blood pressure comes as third cause after underweight and unsafe sex by affecting around 64 million of world population (Ezzati et al, 2002). High blood pressure also was estimated to be attributable of causing 9. 3 % of disability in high income countries and 5. % of disability in middle and low income countries. In Europe, around 12. 8% of total disability –adjusted life-years estimated to cause by hypertension (World Health Organization 2002). This high predicted rate of prevalence of high blood pressure represents a real challenge for the decision-makers in health field in the whole world public and nongovernmental organizations as well as world health organizations. One of the most important of which, is the high financial cost.
For example, only in UK the high blood pressure medication cost around ? 409 million yearly (BHS strategic review, 2010), and in The USA the high blood pressure medication cost about $17. 8 billion yearly (Thom et al, 2006). As result of higher prevalence of high blood pressure was among low educated people in comparing to high educated people, this explains how awareness is another burden to promote among less educated people.
In the other hand increase of awareness among educated people makes it easier to following instruction that prevent developed high blood pressure. (Psaltopoulouet al, 2004). According to the seventh report of the Joint National Committee on the Prevention, Detections, Evaluation and Treatment of high blood pressure. Anti- hypertensive medicines recommend for individuals whose their systolic blood pressure is 140 mmHg or higher and/or their diastolic blood pressure is 90 or higher (Chobanian et al, 2003).
Although there is strong evidence on the effectiveness of pharmacological therapy in reducing high blood pressure, but the negative potential of the side effects and its high cots still considered a worrying factor in some middle and low income countries(Chobanian et al, 2003). For those who are considered as pre-hypertensive individuals the changing of life style recommended as the first line and also it considered as a treatment in combination with drugs in hypertensive people (World Health Organization, 2003).
Life style related factors has significant impact on prevalence of high blood pressure, promoting these factors such as encouraging physical activity, decrease weight, following healthy diet and stopping tobacco use have a major influence on decrease blood pressure, while the sedentary life style and unhealthy behaviors such as obesity, physical inactivity, exceeding alcohol drink and smoking are considered of the main risks factor of elevated blood pressure. Chobanian et al, 2003) physical inactivity ranked as the third cause factor of mortality which account for 6% globally. (World Health Organization, 2009) Sedentary and inactive people with high blood pressure have higher rates of mortality than those Who have high blood pressure but fit and more active (ACSM position stand). Physical activity and brisk walking in particular for 30 minute for 5 days per week has been recommended for individuals who had high blood pressure by the sixth report of the Joint National Committee On The Prevention, Detections,
Evaluation and Treatment of High Blood Pressure and by American College of Sport Medicine and the Centers of Diseases Control and Prevention (ACM-CDC) (Moreau et al, 2001). In Saudi Arabia, more than 25% of the adult populations are affected with high blood pressure, the prevalence of high blood pressure account for 26. 1% of Saudi men and almost 24% of women. Urban population presents 27. 9% of the total prevalence, while a lower prevalence of 22. % found in rural areas but a higher prevalence of 30% found in low educated Saudi people in comparison with well educated individuals which accounts for 20% (Alnozha et al, 2007). A cardiovascular disease affects around 8. 2% of the hypertensive Saudi population and 4. 5% in those who do not have high blood pressure (Alnozha et al, 2007). Treatment of both high blood pressure and diabetes cost Saudi government about 2 billion bound yearly (Khojah, 2006) There is no official report about the cost of hypertension alone.
This prevalence of hypertension in Saudi Arabia is not surprising if we know that the majority of Saudi people are physically inactive due to several important factors. The main factor is the weather which impairs people activity and make them dependant on air conditioned transport and facilities. Saudi Arabia considered a desert country and its weather generally is hot and dry and humid in costal areas. The summer lasts for almost 6 months and temperature ranging from 35-50 degree Celsius.
In addition a pattern of social life is the most important reason, where the vast majority of Saudi Arabia’s population of Bedouin tribes who still sticking to their customs and traditions. Like these habits are impediment to exercise and regular physical activities. The majority affected category is people who are married, involved in social and family activities and those who are aged more than 40 years old, affecting both genders. Another important factor which hinders the people from practicing any physical activity is scarcity of gyms and the high cost of their price which ranging from 200-400 pounds per month.
However such activities become an exclusive for young adult people while women do not have the same privilege that men do due to the traditions and costumes. To conclude all above, Saudi Arabia population like any other developing countries who have higher prevalence of high blood pressure, medication is still the first line but as result of the cost, less awareness , majority of blood pressure individual are from urban areas, high prevalence of less educated people, weather, tradition and ostume, high food intake and physical inactivity are all act as major risk factor causing high blood pressure, contribute to affect individuals in controlling their high blood pressure and it is also a serious risk factor of cardiovascular disease. For that, this study aims to develop a treatment model which helps high blood pressure individuals in Saudi Arabia to decrease and control their high blood pressure in easy way, less costing, fit the Saudi culture, life style, and overcome the weather obstacle.
Taking into counter the evidence on exercise in reducing the blood pressure, and walking in particular. The question arise, does promote walking among Saudi individuals could be the solution to overcome the co-morbidity factors and become a step stone in managing the high blood pressure. Not to forget to mention that walking suits any member of the society regardless the age, gender, social and traditions attributes, and does not cost more than comfortable athletic shoes.