Environmental and Lifestyle Risk Factors for Hypertension and Prehypertension: A Cross-Sectional Analysis of the KNHANES 2022

Purpose - This study aims to investigate the multifactorial determinants of blood pressure abnormalities in South Korea by examining the associations between sociodemographic characteristics, metabolic and lifestyle factors, and environmental exposures with normal blood pressure, prehypertension, and hypertension. Design/Methodology/Approach - Complex survey design methods were employed to ensure representativeness. Descriptive statistics, univariate analyses, and multivariable logistic regression models were used to assess the associations between demographic, socioeconomic, lifestyle, metabolic, and environmental factors with blood pressure status. Findings - The results indicate that advanced age, male gender, lower socioeconomic status, and adverse metabolic profiles are significantly associated with increased odds of both prehypertension and hypertension. Notably, exposure to air pollutants—including PM10, NO₂, CO, and O₃—was positively correlated with the risk of hypertension. Geographic visualization revealed marked regional differences, with the Gyeonggi region and Seoul exhibiting the highest prevalence rates, while regions such as Sejong and Jeju showed considerably lower rates. The multivariable logistic regression further confirmed that both individual and environmental factors contribute to the risk of blood pressure abnormalities, highlighting the complex interplay of these determinants. Research Implications - These findings underscore the need for integrated, region-specific public health strategies that address not only traditional metabolic and behavioral risk factors but also environmental exposures. The study provides a scientific basis for early screening and targeted interventions, particularly in urbanized and highly polluted regions. Future research should incorporate longitudinal designs and high-resolution exposure assessments to further clarify causal relationships and refine prevention strategies for hypertension.