Associations of Weekend Warrior and Regular Physical Activity Patterns with Prevalence of Hypertension by Socioeconomic Status in Korean Adults.

Background:Evidence shows that the weekend warrior physical activity (PA) pattern (1-2 days/week) is associated with a lower risk of hypertension, but it is unclear whether this association differs by socioeconomic status (SES). This study aimed to examine whether the association between the weekend warrior PA pattern and prevalent hypertension differs according to SES in Korean adults. Methods:We analyzed 28,039 adults (aged ≥ 19 years) from the 2018-2023 Korea National Health and Nutrition Examination Survey. PA patterns were categorized as inactive, insufficiently active, weekend warrior, or regularly active. Educational attainment (high school or less vs. college or higher) and household income (Q1-Q2 vs. Q3-Q4) were used as proxies of SES. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, a physician diagnosis, or use of antihypertensive medication. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent hypertension across PA patterns, stratified by educational attainment and household income level. Results:Among 28,039 adults, 8,842 (31.5%) had hypertension. In multivariable-adjusted models, compared with inactive participants, insufficiently active (OR, 0.85; 95% CI, 0.77-0.93), weekend warrior (OR, 0.74; 95% CI, 0.59-0.92), and regularly active (OR, 0.84; 95% CI, 0.77-0.91) PA patterns were each associated with lower odds of prevalent hypertension. There was no significant educational attainment-by-weekend warrior interaction for prevalent hypertension (P for interaction = 0.349), whereas a significant household income-by- weekend warrior interaction was observed (P for interaction = 0.049), with a more pronounced inverse association among lower-income adults. Conclusions:PA patterns, including the weekend warrior pattern, were associated with lower odds of prevalent hypertension among Korean adults. The inverse association between the weekend warrior pattern and hypertension appeared to differ by household income level, with a more pronounced inverse association among lower-income adults. Further studies in large longitudinal cohorts are warranted to confirm these findings.