Key result
Low health literacy was associated with a higher frequency of elevated blood pressure at hospital presentation compared to adequate health literacy (40.0% vs. 35.5%; aOR 1.06; 95% CI, 1.01-1.12).
Why the study?
Does low health literacy increase the risk of elevated blood pressure at hospital presentation in adult hospitalized patients?
Cross-Sectional (n=46,263)
No
Does low health literacy increase the risk of elevated blood pressure at hospital presentation in adult hospitalized patients?
Low health literacy is independently associated with a higher likelihood of presenting to the hospital with elevated blood pressure, particularly among patients without a prior diagnosis of hypertension.
Answers are grounded in this paper and cite their sources.
Low health literacy was associated with elevated admission BP; leaves open causal effects and need for prospective intervention trials.
BACKGROUND: The clinical consequences of low health literacy are not fully understood. OBJECTIVES: We evaluated the relationship between low health literacy and elevated blood pressure (BP) at hospital presentation. RESEARCH DESIGN AND SUBJECTS: We conducted a cross-sectional evaluation of adult patients hospitalized at a university hospital between November 1, 2010 and April 30, 2012. MEASURES: Health literacy was assessed using the Brief Health Literacy Screen (BHLS). Low health literacy was defined as a BHLS score ≤9. BP was assessed using clinical measurements. The outcome was elevated BP (≥140/90 mm Hg; ≥130/80 mm Hg with diabetes or renal disease) or extremely elevated BP (>160/100 mm Hg) at hospital presentation. Multivariate logistic regression adjusted for age, sex, race, insurance, comorbidities, and antihypertensive medications; preplanned restricted analysis among patients with diagnosed hypertension was performed. RESULTS: Of 46,263 hospitalizations, 23% had low health literacy, which occurred more often among patients who were older (61 vs. 54 y), less educated (28.4% vs. 11.2% had not completed high school), and more often admitted through the emergency department (54.3% vs. 48.1%) than those with BHLS>9. Elevated BP was more frequent among those with low health literacy [40.0% vs. 35.5%; adjusted odds ratio (aOR) 1.06; 95% confidence interval (CI), 1.01-1.12]. Low health literacy was associated with extremely elevated BP (aOR 1.08; 95% CI, 1.01-1.16) and elevated BP among those without diagnosed hypertension (aOR 1.09; 95% CI, 1.02-1.16). CONCLUSIONS: More than ⅓ of patients had elevated BP at hospital presentation. Low health literacy was independently associated with elevated BP, particularly among patients without diagnosed hypertension.
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McNaughton et al. (2014) conducted a cross-sectional in Elevated blood pressure (n=46,263). Low health literacy (BHLS score ≤9) vs. Adequate health literacy (BHLS >9) was evaluated on Elevated blood pressure (≥140/90 mm Hg; ≥130/80 mm Hg with diabetes or renal disease) at hospital presentation (aOR 1.06, 95% CI 1.01-1.12). Low health literacy was associated with a higher frequency of elevated blood pressure at hospital presentation compared to adequate health literacy (40.0% vs. 35.5%; aOR 1.06; 95% CI, 1.01-1.12).
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