Association of Health Literacy With Elevated Blood Pressure

A Cohort Study of Hospitalized Patients

Bibliographic Data

ID9102219
AuthorsCandace D McNaughton (0000-0003-0095-9134, Vanderbilt University, corresponding author), Sunil Kripalani (0000-0002-4214-7129), Courtney Cawthon (Vanderbilt Health), Lorraine C Mion (0000-0003-2886-142X, Vanderbilt University), Kenneth A Wallston (0000-0001-6310-0306, Vanderbilt University), Christianne L Roumie (0000-0002-6555-2055, Veterans Health Administration)
Year2014
Volume52
Issue4
Pages346-353
Publication date2014-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000101
PMID24556896
PMCIDPMC4031281
OpenAlexW1980707505
LanguageEN
Citations received4
References cited9

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 1⁄3 of patients had elevated BP at hospital presentation. Low health literacy was independently associated with elevated BP, particularly among patients without diagnosed hypertension

Blood pressure · Confidence interval · Diabetes mellitus · Emergency department · Health care · Health literacy · Logistic regression · Odds ratio · Blood Pressure and Hypertension Studies · Health Literacy and Information Accessibility · Internal Medicine · Medicine · Nursing · Smoking Behavior and Cessation

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