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Internal and Emergency Medicine

, Volume 12, Issue 6, pp 765–776 | Cite as

Association between health literacy and hypertension management in a Chinese community: a retrospective cohort study

  • Di Shi
  • Jiangbo Li
  • Yong Wang
  • Si Wang
  • Kai Liu
  • Rufeng Shi
  • Qiang Zhang
  • Xiaoping ChenEmail author
IM - ORIGINAL

Abstract

Low health literacy is associated with poor clinical outcomes. The relationship between literacy and blood pressure (BP) has been inconsistent. We investigated the determinants of health literacy and the potential relationship between health literacy and hypertension management. We conducted a retrospective cohort trial of 360 hypertensive patients. Scale measurements, physical examination, and laboratory tests were performed based on a standard protocol. To determine factors associated with health literacy, multiple logistic regression analysis was performed and the discriminatory power of the scale score for hypertension control was assessed by the area under the receiver operating curve. After adjusting for potential confounders, our findings show that the level of education, home blood pressure measurement, regular medication, and systolic blood pressure are significantly associated with health literacy. Moreover, patients with high health literacy have better hypertension control, a lower risk of ischemic cardiovascular disease (ICVD), lower brachial ankle pulse wave velocity values, and better health-related quality of life. In addition, our study also demonstrates that we can identify the health literacy level of hypertensive patients using the Chinese Health Literacy Scale for Hypertension. At a cut-off value of 13.5, we predict that patients will achieve long-term hypertension control. Adequate health literacy is a contributing factor to better blood pressure (BP) control and better perceived quality of life in hypertensive patients. Low health literacy increases the 10-year risk of ICVD and incidence of artery stiffness in hypertensive patients. Improving health literacy should be considered an important part of the management of hypertension.

Keywords

Health literacy Hypertension Home blood pressure Blood pressure control 

Notes

Acknowledgements

The authors thank Dr. Xiao’s team at Jinyang Community Health Center in Chengdu, China for their contributions to this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests (financial, political, personal, religious, ideological, academic, intellectual, or any other) to declare in relation to this manuscript.

Statement of human and animal rights

The research protocol was reviewed by the Medical Ethics committee of West China Hospital, Sichuan University. The study protocol conforms with the ethical guidelines of Declaration of Helsinki.

Informed consent

Informed written consent was obtained from patients before enrollment. The Medical Ethics Committee of West China Hospital Sichuan University approved all procedures.

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Copyright information

© SIMI 2017

Authors and Affiliations

  • Di Shi
    • 1
  • Jiangbo Li
    • 1
  • Yong Wang
    • 1
  • Si Wang
    • 1
  • Kai Liu
    • 1
  • Rufeng Shi
    • 1
  • Qiang Zhang
    • 1
  • Xiaoping Chen
    • 1
    Email author
  1. 1.Department of CardiologyWest China Hospital, Sichuan UniversityChengduChina

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