Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk. (29th August 2020)

• Record Type: Journal Article
• Authors: Lindahl, Bernt; Norberg, Margareta; Johansson, Helene; Lindvall, Kristina; Ng, Nawi; Nordin, Maria; Nordin, Steven; Näslund, Ulf; Persson, Amanda; Vanoli, Davide; Schulz, Peter J
• Is Part Of: European journal of preventive cardiology. Volume 27:Number 2(2020)
• Page Start: 209
• Page End: 215
• Publication Date: 2020-08-29
• Subjects: Health literacy -- ultrasound -- carotid artery plaque -- cardiovascular risk scores; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1177/2047487319882821
• Languages: English
• ISSNs: 2047-4873

Abstract

Abstract: Aims: Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors. Methods: Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated. Results: About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results. Conclusions: Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.