Health Behavior Patterns Associated With Cardiovascular Risk in Korean College Students

Background: Cardiovascular diseases are a leading cause of mortality, with a rising prevalence in younger populations. Objective: In this study, we aimed to identify health behavior patterns among Korean college students using latent class analysis and examine associations with cardiometabolic and psychological risk indicators. Methods: In this cross-sectional study, we evaluated 417 college students aged 19–29 years from the 2022–2023 Korea National Health and Nutrition Examination Survey. Latent class analysis indicators included sleep duration, physical activity, smoking status, binge drinking, and breakfast consumption. Cardiovascular risk indicators were low-density lipoprotein (LDL), high-density lipoprotein, triglycerides, body mass index (BMI), and perceived stress. Differences across latent classes were tested using the Bolck-Croon-Hagenaars method. Results: Three health behavior patterns were identified: regular-sleep–breakfast-consistent (15.0%), physically active/nonsmoking (70.0%), and multiple-risk behavior groups (15.0%). Significant differences across classes were observed for LDL ( P < .001), BMI ( P < .001), and perceived stress ( P = .048). The regular-sleep–breakfast-consistent group had the most favorable profile, with lower BMI and perceived stress. The multiple-risk behavior group had higher BMI and stress. The physically active/nonsmoking group had relatively higher LDL, despite otherwise favorable behaviors. Conclusions: Health behaviors clustered into distinct patterns and were differentially associated with biological and psychological risk indicators. These findings emphasize considering co-occurring lifestyle behaviors and incorporating objective biomarkers in cardiovascular risk assessment. Interventions targeting multiple behaviors, including sleep and diet, may be more effective than single-behavior approaches. Campus and primary care nurses may implement integrated behavioral screening and brief interventions, supporting early cardiovascular risk prevention in young adults.