Stepping Towards Health: A Cross-Sectional Study of Hypertension, Mobility, and Endurance Among Saudi Adults Aged 50 Years and Older.

Background/Objectives: Hypertension (HTN) is highly prevalent among middle-aged and older adults in Saudi Arabia, affecting nearly half of those attending primary care clinics. This growing burden contributes not only to cardiovascular disease, but also to functional decline and reduced mobility in aging Saudis. The objective of this paper was to examine the relationship between HTN and objective measures of mobility and endurance in Saudi adults aged ≥50 years, and to assess whether any associations differ by sex. Methods: In a cross-sectional study, 47 hypertensive and 53 non-hypertensive (no chronic disease) community-dwelling adults were recruited from various regions of Saudi Arabia. Participants completed mobility tests (five repetitions of sit-to-stand (5×STS) and timed up-and-go (TUG)) and an endurance test (6 min walk test (6MWT)). Multivariable linear regressions adjusted for age, body mass index, and sociodemographic factors were used to evaluate the association of HTN with each performance measure in men and women separately. Results: Participants with HTN were older (mean 63 vs. 57 years) and had higher BMI than controls (p < 0.05), as well as performing worse on all functional tests: they required more time for 5×STS and TUG, and walked a shorter distance during the 6MWT (all p ≤ 0.003). In sex-stratified analyses, HTN was associated with slower TUG in men (≈2 s longer, p = 0.027), while among women, HTN predicted significantly slower 5×STS (+8.4 s) and TUG (+2.8 s) times, and a 114 m-shorter 6MWT distance (p < 0.05 each). Conclusion: HTN is linked to impaired mobility and endurance in middle-aged and older Saudi adults, with hypertensive women exhibiting particularly pronounced deficits. Future research is needed to determine whether incorporating routine functional assessments and exercise-based counseling into HTN care may help identify and address early declines in physical independence among aging adults.