Abstract
BACKGROUND: Hypertension, a significant risk factor for global public health, is well-known to be preventable and manageable through physical activity (PA). However, many studies suggest that excessive PA may not provide additional benefits. Thus, we aimed to conduct a quantitative analysis of the relationship between hypertension and PA levels. METHODS: This study analyzed the association between PA and hypertension using data from 2,429,588 South Korean adults aged 30 years and older from the Korean Community Health Survey conducted from 2009 to 2022. We used weighted binary logistic regression and generalized additive models to examine the relationship, adjusting for various sociodemographic factors. PA was categorized into moderate-intensity PA (MPA) and vigorous-intensity PA (VPA) based on World Health Organization guidelines to study the association between hypertension and PA intensity. RESULTS: The greatest reduction in hypertension risk was associated with 1,090 metabolic equivalent of task (MET) minutes per week, with no additional reduction beyond this point. Additionally, MPA (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.90-0.93) had a stronger association with reducing hypertension risk compared to VPA (OR, 0.95; 95% CI, 0.94-0.97) at higher levels of PA (> 1,800 MET minutes per week). Subgroup analyses showed that older age, lower education level, and lower income were associated with greater reductions in hypertension risk at the same PA levels. CONCLUSIONS: Moderate amounts of PA are associated with a lower risk of hypertension, but additional activity beyond this may not provide further benefits. With a high amount of PA, MPA is more effective than VPA in reducing hypertension risk. Since the effectiveness of PA in preventing hypertension varies across different sociodemographic factors, appropriate policies tailored to specific groups are necessary.