Health literacy and adherence to physical activity guidelines among adults with hypertension: evidence from a Korean National Survey.

Objective: Hypertension is a major contributor to premature mortality and global disease burden. Physical activity is a key non-pharmacological management strategy; however, adherence remains low. Health literacy may influence health behaviors, yet its association with physical activity among individuals with hypertension is unclear. This study examined the relationship between health literacy and physical activity guideline adherence in Korean adults with hypertension using nationally representative data. Methods: We conducted a secondary analysis of the 2023 Korea National Health and Nutrition Examination Survey using multistage stratified cluster sampling. Among 1420 adults with hypertension, health literacy was assessed with a 10-item scale, with scores ≥30 indicating adequacy. Physical activity adherence followed World Health Organization guidelines: at least 150 min of moderate, 75 min of vigorous activity, or an equivalent combination per week. Complex sample logistic regression analyses were performed, adjusting for sociodemographic, health, behavioral, and psychosocial covariates. Results: Adults with adequate health literacy had significantly higher odds of meeting recommended activity levels. Younger age, higher education, better self-rated health, and absence of activity restriction were also positively associated. Conclusions: Health literacy is a key determinant of physical activity in adults with hypertension. Enhancing health literacy may improve hypertension management.