Purpose: To examine the association between physical activity, prevalence of hypertension, and total healthcare and pharmaceutical expenditure in the United States of America (US).

Methods: In this cross-sectional study, adult United States residents were included from the Medical Expenditure Panel Survey (MEPS) for 2002. In the MEPS, physical activity was defined as spending at least 30 min 3 times a week in moderate to vigorous physical activity and the diagnosis of hypertension was based on the patient’s self-report. Logistic and multiple linear regression models were used to calculate the risk of prevalent hypertension in physically inactive individuals and examine the association between physical activity and healthcare expenditure after controlling for confounders.

Results: Hypertensive patients who were physically active accounted for 46 % and the risk of hypertension was higher in physically inactive individuals than in those who were physically active (Odds ratio, 1.1; 95 % Confidence interval, 1.07 to 1.12, p < 0.0001). Physical activity in all individuals was associated with a decrease in total healthcare expenditure by US$592 per person (p < 0.0001) and pharmaceutical expenditure by US$125 per person (p < 0.0001).

Conclusion: Total healthcare and pharmaceutical expenditures were significantly lower for physically active than physically inactive individuals.