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. 2025 Apr 30;25(1):1586.
doi: 10.1186/s12889-025-22806-0.

Association between physical activity behaviors and hypertension with comorbid multiple chronic diseases in South Korean middle-aged and elderly: an analysis based on association rule

Yingcheng Huang  1 , Daeyeon Lee  2
Affiliations

Association between physical activity behaviors and hypertension with comorbid multiple chronic diseases in South Korean middle-aged and elderly: an analysis based on association rule

Yingcheng Huang et al. BMC Public Health. .

Abstract

Background: The increasing prevalence of multiple chronic diseases in aging populations presents a serious public health concern. Hypertension, as one of the most common chronic conditions, is frequently observed alongside other chronic diseases such as diabetes, obesity, and dyslipidemia. Physical activity is widely acknowledged to be associated with the prevention and management of chronic diseases. However, few studies have examined how different Physical activity behaviors are associated with specific multimorbidity patterns involving hypertension. This study aimed to identify the patterns of association between physical activity status and co-occurring chronic conditions among hypertensive individuals in middle-aged and older adults in South Korea, using association rule analysis.

Methods: Our study utilized data from the Korean National Health and Nutrition Examination Survey (2016-2021), involving 21,043 participants aged 45 years and older. A total of 25 chronic diseases were included as related variables for the analysis using association rule mining.

Results: In the middle-aged and elderly population in South Korea, hypertension has the highest prevalence among all chronic diseases, with a rate of 45%. Our association rule analysis identified a total of nine chronic conditions as antecedents, with diabetes, obesity, and dyslipidemia being the most frequently observed. Furthermore, a subgroup comparison revealed that the number of association rules identified in the 'physically inactive' group (25 rules) was higher than that in the 'physically active' group (17 rules), and the overall confidence levels in the 'inactive' group were also higher. In terms of the frequency of antecedents, stroke, cardiovascular disease, and arthritis showed the largest increases.

Conclusion: Adequate physical activity is vital for preventing and managing hypertension and reducing its comorbidities, particularly high-mortality conditions like cardiovascular disease and stroke. Promoting lifestyle changes and monitoring metabolic indicators can significantly lower hypertension incidence, improve quality of life, and reduce mortality.

Keywords: Association rule; Hypertension; Multiple chronic diseases; Physical activity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Each individual who participated in this research study granted their informed consent prior to their inclusion. The survey was carried out with the official approval of the Research Ethics Review Committee at the Korea Centers for Disease Control and Prevention, under the reference number 2018-01-03-P-A. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of Association Rules between Physical Activity Subgroups
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