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September 3, 2026The Korean Journal of Sports MedicineOpen Access

Meeting all three 24-hour movement guidelines is linked to ~29% lower hypertension odds versus none.

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Why the study?

While regular physical activity lowers blood pressure, 24-hour movement behaviors integrating physical activity, sedentary behavior, and sleep may offer a more comprehensive framework for cardiovascular health.

Does adherence to 24-hour movement guidelines reduce the prevalence of hypertension in Korean adults?

Population

23,410 adults aged ≥19 years in Korea

Comparison

Adherence to 24-hour movement guidelines across components met vs none

Design

Cross-sectional study

Key result

Adherence to all three 24-hour movement guidelines was independently associated with a 29% lower odds of hypertension compared to meeting none of the guidelines (OR 0.71).

Authors

SKS. KimTCTae Gu ChoiBKByul Kim

Discussion

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Overview

May support integrated movement counseling in primary care; leaves open causality and requires prospective confirmation before guideline updates.

Key Points

  • To assess the relationship between adherence to 24-hour movement guidelines (physical activity, sedentary time, and sleep) and the prevalence of hypertension in Korean adults.
  • Analyzed cross-sectional data from 23,410 adults aged ≥19 years in the Korea National Health and Nutrition Examination Survey (2018–2023).
  • Assessed adherence to three guideline components: leisure-time moderate-to-vigorous physical activity (≥150 min/week), sedentary duration (≤8 hr/day), and age-appropriate sleep duration.
  • Identified hypertension based on systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, physician diagnosis, or use of antihypertensive medication.
  • Guideline adherence rates were 19.8% for zero guidelines, 42.9% for one guideline, 31.7% for two guidelines, and 5.7% for all three guidelines.
  • Hypertension prevalence was lowest among individuals meeting all three guidelines compared to those meeting none (21.5% vs. 35.2%, p < 0.001).
  • Following multivariable adjustment, only adherence to all three guidelines was independently associated with reduced hypertension prevalence (OR, 0.71; 95% CI, 0.60–0.84).

Study Design

Type

Cross-Sectional (n=23,410)

Structured PICO

Does adherence to 24-hour movement guidelines reduce the prevalence of hypertension in Korean adults?

P
Population
23,410 Korean adults aged 19 years or older from a nationally representative survey assessed for adherence to 24-hour movement guidelines and hypertension prevalence.
E
Exposure
Adherence to 24-hour movement guidelines (meeting 1, 2, or all 3 components: leisure-time moderate-to-vigorous physical activity ≥150 min/week, sedentary time ≤8 hr/day, and age-specific sleep duration recommendations).
C
Comparator
Meeting none of the 24-hour movement guideline components.
O
Outcome
Prevalence of hypertension (defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, physician-diagnosed hypertension, or current antihypertensive medication use).surrogate

Main Result

Odds Ratio: 0.71 (95% CI 0.6–0.84)

Absolute Event Rate: 21.5% vs 35.2%

p-value: p=<0.001

Simultaneous adherence to physical activity, sedentary behavior, and sleep guidelines is independently associated with a lower prevalence of hypertension, highlighting the importance of integrated 24-hour movement behaviors for cardiovascular health.

Limitations

  • Cross-sectional study design precludes causal inferences.
  • Movement behaviors were assessed using self-reported measures and may be subject to recall and social desirability bias.
  • Categorizing participants by the number of guideline components met may not fully capture the complexity or compositional nature of daily time-use behaviors.
  • Potential residual confounding due to unmeasured factors such as dietary factors, psychological stress, and underlying diseases.
  • Movement behaviors were assessed using self-reported measures, subject to recall and social desirability bias.
  • Categorizing participants by number of guideline components met may not fully capture the complexity of daily time-use behaviors.

Cite This Study

Kim et al. (2026) conducted a cross-sectional in Hypertension (n=23,410). Adherence to all three 24-hour movement guidelines vs. Meeting none of the guidelines was evaluated on Prevalence of hypertension (OR 0.71, 95% CI 0.60-0.84, p=<0.001). Adherence to all three 24-hour movement guidelines was independently associated with a 29% lower odds of hypertension compared to meeting none of the guidelines (OR 0.71).

synapsesocial.com/papers/6a9934cf636c6408cfa7c89chttps://doi.org/10.5763/kjsm.2026.44.3.184
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