The linkage between growing older, increased exercise and the management of blood pressure

This chapter provide an overview of cardiovascular disease, hypertension, exercise, and background to hypertension.

1.1 Background to cardiovascular disease

The prevalence of chronic health conditions is significantly increasing globally (Hajat and Stein, 2018). These can be attributed to various factors which increase an individual's risk of developing the disease. Some of these conditions require lifetime follow-up, with some resulting in potentially life-threatening complications. The regular follow-ups and medications required in managing these conditions are also resource-intensive, resulting in a financial burden to the affected patients as well as their families and friends (Hajat and Stein, 2018). Besides, the various chronic conditions affect the physical and mental health of affected patients, thereby resulting in poor quality of life (Hajat and Stein, 2018).

This paper focuses on cardiovascular diseases, one of the chronic health conditions and among the leading cause of death globally (Timmis et al., 2020). They include a wide range of conditions, such as coronary heart disease, cerebrovascular diseases, rheumatic heart diseases, congenital heart diseases, peripheral artery diseases, and deep venous thrombosis, which can complicate pulmonary embolism (Timmis et al., 2020). Stroke and heart attacks are often acute life-threatening events due to inadequate or blockage of blood supply to the brain and heart, respectively, although stroke can also occur due to bleeding of brain vessels (Battaglini et al., 2020). Like any other conditions, patients with cardiovascular diseases present with certain symptoms, including chest pain, dizziness, difficulty breathing, and syncopal attacks. Besides, certain risks expose an individual to a danger of developing these conditions, for instance, unhealthy diet, lack of physical activity, and harmful use of alcohol and tobacco smoking (Virani et al., 2021). 

1.2 Global Statistics of Cardiovascular Diseases

Cardiovascular diseases are a global health concern, affecting millions of people regardless of their racial or ethnic backgrounds. According to the WHO (2021) report on non-communicable diseases of 11th June 2021, cardiovascular diseases were identified as the leading cause of death worldwide. Besides, in 2019, approximately 17.9 million were reported to have died from cardiovascular diseases, which corresponded to approximately 32% of total global deaths the same year (Timmis et al., 2020). 85% of all cardiovascular deaths were also due to heart attack and stroke (WHO, 2021). Additionally, more than 75% of the deaths were reported in low and middle-income countries (WHO, 2021). Of the 17 million premature deaths recorded in the same year, which implied death for those below 70 years due to non-communicable diseases, cardiovascular diseases were the leading contributor, with an estimated 38% of all deaths (Timmis et al., 2020).

According to the European Heart Journal, cardiovascular diseases contribute to approximately 34% of deaths in the Middle East, which is slightly above the global estimate of 32%. The journal also identifies dyslipidemia as a significant independent risk factor for developing cardiovascular disease in the Middle East (Sardarinia et al., 2016). Cardiovascular diseases were also responsible for almost half of deaths in Kuwait and Oman, with an estimated 46% and 49%, respectively. Other regions within the Middle East, such as Qatar, Bahrain, UAE, and Saudi Arabia, also recorded significant deaths due to cardiovascular diseases, with an estimate of 23%, 32%, 38%, and 42% of total deaths, respectively (Sardarinia et al., 2016). The high prevalence of cardiovascular diseases within the Middle East countries has been attributed to the rapid socioeconomic growth, which has resulted in a change in people's lifestyles. 

Hypertension is also common in the Middle East, contributing to approximately 39% of all cardiovascular-related deaths in Lebanon and 28% in the UAE (Sardarinia et al., 2016). Other risk factors implicated in the high prevalence of cardiovascular diseases in the Middle East include diabetes, with 6 of the world’s top 10 nations with diabetes coming from the Middle East (Sardarinia et al., 2016). There is also a high prevalence of obesity, especially among the Middle East female population, and a high smoking prevalence among Jordanian males at 61%, ranked 8th globally. Research such as the INTERHEART and Gulf-RACE found that the prevalence of heart attack is higher and at a younger age, ranging from 45 to 50 among patients in the Middle East, which is 10 to 12 years earlier compared to their counterparts in the West (Sardarinia et al., 2016). Such statistics show why this issue is a major concern for the Middle East population, given that it is expected to rise if no measures are put to address the r