Association between Adherence to 24-Hour Movement Guidelines and the Prevalence of Hypertension in Korean Adults: A Cross-sectional Study

Purpose: Although regular physical activity is known to lower blood pressure, 24-hour movement behaviors integrating physical activity, sedentary behavior, and sleep may provide a more comprehensive framework for cardiovascular health.This study examined the association between adherence to the 24-hour movement guidelines and hypertension prevalence among Korean adults.Methods: We analyzed data from 23,410 adults aged ≥19 years from the Korea National Health and Nutrition Examination Survey 2018-2023.Adherence to the 24-hour movement guidelines was classified according to the number of components met: leisure-time moderate-to-vigorous physical activity ≥150 min/week, sedentary time ≤8 hr/day, and age-specific sleep duration recommendations.Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, physician-diagnosed hypertension, or current antihypertensive medication use.Results: Overall, 19.8% of participants met none of the guidelines, 42.9% met one guideline, 31.7% met two guidelines, and 5.7% met all three guidelines.Hypertension prevalence was lowest in participants meeting all three guidelines, compared with those meeting none of the guidelines (21.5% vs. 35.2%,p<0.001).After adjustment for potential confounders, only meeting all three guidelines remained significantly associated with lower hypertension prevalence (odds ratio, 0.71; 95% confidence interval, 0.60-0.84).Conclusion: Adherence to all three 24-hour movement guidelines was uncommon in Korean adults but was independently associated with lower hypertension prevalence.These findings suggest that integrated movement behavior recommendations may be relevant for hypertension prevention.