Bernt Lindahl1, Margareta Norberg2, Helene Johansson3, Kristina Lindvall3, Nawi Ng3, Maria Nordin4, Steven Nordin4, Ulf Näslund5, Amanda Persson2, Davide Vanoli5, Peter J Schulz6. 1. Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden. 2. Section of Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden. 3. Department of Epidemiology and Global Health, Umeå University, Sweden. 4. Department of Psychology, Umeå University, Sweden. 5. Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden. 6. Institute of Communication and Health, University of Lugano, Switzerland.
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.
RCT Entities:
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.
Entities:
Keywords:
Health literacy; cardiovascular risk scores; carotid artery plaque; ultrasound
Authors: Ana Cristina Cabellos-García; Antonio Martínez-Sabater; Miguel Ángel Díaz-Herrera; Vicente Gea-Caballero; Enrique Castro-Sánchez Journal: BMC Public Health Date: 2021-07-09 Impact factor: 3.295